Cardiff Community Health Council
Annual Report 2008 – 2009
CONTENTS
Page
Contents 2
Cardiff Community Health Council 3
How to Contact - Cardiff Community Health Council 4
Chair’s Report
5
Chief Officer’s Report - Statement of Expenditure at Year End 31st March 2009
and Consultations
6
Monitoring Visits Undertaken
17
Public and Patient Involvement
29
Cardiff and Vale of Glamorgan Community Health Councils Complaints
Advocacy Report
35
Future Plans for 2009-2010
43
Additional Information
(i) Council Membership 1st April 2008 - 31
st March 2009
44
(ii) Members Attendance at Council Meetings 2008 - 2009
45
(iii) Examples of Attendance at Conferences / Seminars / Lectures 47
Frequently Used Abbreviations
Child and Adolescent Mental Health Services CAMHS
Community Health Council CHC
Delayed Transfer of Care DTOC
Health Commission Wales (Tertiary Services) HCW
Health, Social Care and Well Being HSCWB
Local Health Board LHB
Local Service Board LSB
Programme for Health Service Improvement Project PHSI Project
Public Reference Group PRG
Welsh Assembly Government WAG
3
CARDIFF COMMUNITY HEALTH COUNCIL
Cardiff Community Health Council (CHC) is the Independent Voice of the Public and Patients –
the consumers in Health Service matters.
As the authorities responsible for Health Services locally are not elected bodies, there is a very
real need for the public’s views to be represented and your interests to be protected.
CHCs are composed of local people who volunteer to monitor the local NHS. They are appointed
by Welsh Assembly Government, County Councils and the Voluntary Sector.
What is our duty?
CHCs are situated across Wales and have four main statutory duties:
• To keep under review from a patient and public perspective the local NHS services
• To facilitate consultation with the public and patients on major changes aimed at local
health services
• To enable local people to have a say about their health services
• To provide an independent advocacy service for those who wish to complain about the
NHS.
What do we do in practice?
The main activities are
• Regular monitoring visits by CHC members to Health Service premises, followed by
recommendations for any required improvements
• Carry out surveys on patients’ needs
• CHCs are consulted by the NHS on proposed changes to services or premises
• Advising local NHS bodies on new services and ideas ensuring the Public and Patient
view is taken into account
• Providing an independent Advocacy Service to patients who wish to make a complaint
against the NHS, under the NHS Complaints Procedure
How can you get involved?
If you feel that you would like to volunteer to become a member of the CHC please contact the
CHC Office on 029 20 377407 or email [email protected]. For further information,
you can visit our website at www.patienthelp.wales.nhs.uk/cardiff
4
HOW TO CONTACT - CARDIFF COMMUNITY HEALTH COUNCIL
Postal Address Ground Floor
Park House
Greyfriars Road
Cardiff
CF10 3AF
Telephone 029 20377407
Fax 029 20665470
Website www.patienthelp.wales.nhs.uk/cardiff
Chief Officer
Mr Martyn Jenkins
Email: [email protected]
PA to Chief Officer
Miss Amanda Stokes
Email: [email protected]
Primary Care / Patient & Public
Involvement Officer
Mr Stephen Allen 029 20 377409
Email: [email protected]
Patient Advocates Mrs Cathy Moss 029 20 377432
Email [email protected]
Mrs Samantha Perrett 029 20 377431
Email: [email protected]
Advocacy Support Officer Mrs Wendy Orrey 029 20 377413
Email: [email protected]
5
CHAIR’S REPORT - DR GWYNETH BRIWNANT-JONES
Staff and members of Cardiff Community Health Council (CHC) have successfully achieved
their main core duties again this year (2008 – 2009).
The monitoring of a comprehensive range of local NHS services, both planned and
unannounced to Primary Care and Secondary Care establishments have been competently
undertaken and reported, together with responses, in council papers and on the website.
Examples include Mental Health implementation, Cancer Services, Phase 2 of the Women’s
Services Implementation and monitoring of the effectiveness of the Cardiff & Vale NHS Trust,
Velindre NHS Trust and Cardiff LHB Public and Patient Involvement Strategies. Members also
monitor ambulance and patient transport service provision within Cardiff, as well as the progress
of the Welsh Assembly Government (WAG) standards and provide regular feedback to council.
In accordance with new contracts, robust visiting models have also been developed for
Pharmacies and Dental surgeries. The CHC continues to fulfil its independent scrutiny role of
evaluating General Practice (GP) Surgeries by meeting successfully with GP Practices to review
Patient Satisfaction Surveys; this is in the best interest of patients and has proved to be a
constructive process.
To engage with and facilitate local community involvement in relation to NHS issues continues to be a high priority for Cardiff CHC. Both staff and members actively facilitate
Public and Patient Involvement and support and development is provided for the four existing
Public Reference Groups. The Butetown Group is an example of the successes of such Groups.
The CHC representative on the Local Service Board Scrutiny Panel has been successfully
nominated Vice-Chair of the Panel and provides regular reports to the CHC council.
To be consulted on proposals for changes in the NHS services in their area is another
statutory role of the CHC. Members participated and contributed to the local consultation event
related to the WAG documents Proposals to Change the Structure of the NHS in Wales and
Proposals for the Future of CHCs in Wales, for example. As part of the CHC’s role to keep
under review the effects of the WAG’s proposals to restructure the NHS in Wales, the CHC is
represented on the Transition Board and the Planning and Partnership Work-stream. Members
have actively contributed to the WAG Focus Groups and the Chief Officer and Chair contributed
to the Minister’s Review of Cardiff Royal Infirmary. Members and officers constructively
contributed to the Welsh Board of CHCs, participating in conferences and training initiatives.
The Complaints Advocacy Services provides a successful, independent service for Cardiff CHC
and the Vale of Glamorgan CHC; they attend MP and AM surgeries as required. Reports are
published in council papers and on the website; the complaints evaluation is published in the
Annual Report.
My thanks are extended to Martyn Jenkins (Chief Officer), Margaret Davies and Geoff Osborn
(Vice-Chairs) and the staff of the CHC for their valuable support; to the dedicated members who
give of their time and knowledge so generously and the co-operation of staff and members to
achieve another challenging and successful year.
6
CHIEF OFFICER’S REPORT - MR MARTYN JENKINS
STATEMENT OF EXPENDITURE AT YEAR END - 31ST MARCH 2009
This year’s financial report shows that Cardiff Community Health Council (CHC) received
£244,097.00 and spent £243,697.82 – showing a £399.18 under-spend.
This under-spend will not be drawn back by the WAG as in other years. The under-spend will
be held over in a CHC account to assist with the funding of the Agenda for Change implications.
The under-spending has been caused in the main by the normal policy of spending to the budget
limit was changed so that under-spends could be achieved for Agenda for Change costs.
CHC Budget Budget
£
Expenditure
£
Over /
(Under-spent)
£
Fixed Costs
141,011.00 147,376.75 6,365.75
Variable Costs
28,379.00 24,179.23 (4,199.77)
Cardiff & Vale Complaints
Advocacy Service
64,851.00 64,804.56 (46.44)
Patient / Public
Involvement (Funding
from Cardiff LHB and
Velindre NHS Trust)
9,856.00 7,337.28 (2,518.72)
Total
244,097.00 243,697.82 (399.18)
The financial allocation for 2009-2010 is:
Fixed Costs
£
Variable Costs
£
TOTAL
£
Cardiff CHC
158,089 12,771 170,860
Cardiff and Vale Complaints
64,532 1,632 66,164
Patient / Public Involvement
(Funding from Cardiff LHB until
31st September 2009)
Not applicable 4,745 4,745
TOTAL 241,769
7
CHIEF OFFICER’S REPORT - MR MARTYN JENKINS
CONSULTATIONS
As part of its statutory role to facilitate consultation with patients and members of the public on
health issues, Cardiff CHC is given the opportunity to review and comment on a wide range of
consultation documents produced by the Welsh Assembly Government, Nursing & Midwifery
Council and many other organisations.
A selection of the consultation documents members have considered during the last year
includes:
• Welsh Assembly Government: National Framework for Continuing NHS Health Care
Consultation – Miss M Davies, Mrs F Webster and Mr R Woodward
• Cardiff Children and Young People’s Plan 2008-2011: Draft Plan Summary – Dr EN
Cole, Dr C Kerby and Mr R Woodward
• Welsh Assembly Government: Iechyd Meddwl Cymru – A Well Being and Mental Health
Service Fit for Wales discussion paper – Cardiff CHC Mental Health Team
• Welsh Assembly Government Consultation Paper ‘Paying for Care in Wales: Creating a
Fair and Sustainable System’ – Miss M Davies, Dr EN Cole, Mr WT Mosley, Mr RG
Osborn and Mr R Woodward
• Welsh Assembly Government Consultation Paper ‘Draft Statutory Guidance on the Role
and Accountabilities of the Director of Social Services’ – Mrs SJ Hutton, Mr WT
Mosley, Dr KT Rajan and Mr R Woodward
• Welsh Assembly Government Consultation ‘Inspection, Audit and Regulation in Wales,
Delivering Better and Accountable Services for Our Citizens’ – Dr EN Cole, Mr F Lane,
and Mr R Woodward,
Copies of the CHC’s responses are published in the CHC council papers and on the website.
The CHC has also been asked to comment from a patient / public perspective on several other
documents. To comment on readability from a lay point of view.
• Cardiff & Vale NHS Trust – Draft Text for Patient Information Leaflet
• Cardiff & Vale NHS Trust – ‘Your Appointment, Your Responsibility’ Press releases and
posters
Further information on consultations the CHC is or has been involved with
is detailed over the page.
8
WELSH ASSEMBLY GOVERNMENT: PROPOSALS TO CHANGE THE STRUCTURE
OF THE NHS IN WALES
The Welsh Assembly Government (WAG) undertook a 12 week public consultation on
Proposals to Change the Structure of the NHS in Wales, 2nd April 2008 to 25
th June 2008. The
areas for consultation included:
• Abolishing the Internal Market in Wales by providing funding from the Welsh Ministers
or a National Board directly to NHS Trusts and Local Health Boards (LHBs)
• 3 options for establishing a National Health Service for Wales (the National Board)
• A reduction from 22 to 8 LHBs in Wales - including Powys LHB
• Transferring from management and provision of Community Services from NHS Trusts
to LHBs
• The constitution and membership of the new LHBs in Wales
• The constitution and membership of NHS Trusts in Wales
• A possible revised model for providing shared services - such as procurement, certain
legal services and estates advice across Wales.
A copy of the consultation document and / or summary of proposals was circulated to members
of the CHC, CHC Public Reference Group and CHC Carers Group.
Local Consultation Events to discuss the proposals were held across Wales. The Cardiff event
was held on Tuesday 27th May 2008 at Bowchier Hall, Shand House (Blind Institute), Newport
Road, Cardiff. This was attended by CHC members, members of the CHC Public Reference
Group, representatives from Cardiff LHB and other Health organisations, as well as members of
the public.
Dr G Briwnant-Jones attended the Technical Consultation Event held on Tuesday 3rd June 2008,
Large Lecture Theatre, Cardiff University.
Dr G Briwnant-Jones and Mr S Allen attended Welsh Board of CHCs South East Regional
Meeting on the Future Role of CHCs in Wales held on Wednesday 13th August 2008.
To further develop members’ understanding of the proposals, members received a presentation
on the consultation proposals and overview of the NHS structures in England, Northern Ireland
and Scotland at the CHC Business, Training and Development meeting on Tuesday 3rd June
2008
Cardiff Community Health Council Response to Consultation Proposals
Following discussion at the CHC Business, Training and Development meeting held on Tuesday
3rd June 2008, Cardiff CHC formally responded to the consultation proposals in a letter dated
23rd June 2008.
Members felt that the following principles were important in the delivery of improved services
for patients:
• Reducing public confusion over roles.
• Providing a correct balance and equity within the different sectors of health care, resulting
in improved services for patients.
9
• Full support for the removal of the internal market. Although there was concern about how
and what will replace it.
• The need to reduce organisational barriers to improve Patient Pathways and to simplify
accountability.
• The delivery of seamless services involving all the key health service providers including
social care.
• Cognisance of the current development of the local Programme for Health Service
Improvement (PHSI) Project within the Cardiff and Vale of Glamorgan Health
Community.
• The importance of establishing a more integrated approach between health and social
services.
Members supported the establishment of a Special Health Authority - emphasizing the need to
ensure a correct balance between national and local responsibilities, to achieve a more equitable
relationship between Secondary Care and Primary / Community Care Services.
Members did not support the retention of two local provider organisations (ie the LHB and NHS
Trust). A single organisation to integrate hospital and out of hospital services under the strategic
direction of the Special Health Authority was recommended. Furthermore, as noted above,
members supported the need to consider the relationship between Health and Social Services, to
ensure a more integrated approach and improve the patient pathway and experience, which is
“not good enough under the current structures”.
In terms of public / patient engagement processes, members asserted that the new structures must
be subject to robust independent lay scrutiny and challenge. It was noted that the document
identifies the important role that CHCs can play in this context and it was stated in the CHC
response that CHCs should for the time being remain coterminous with their Local Authorities -
to ensure the delivery of the CHC’s current statutory responsibilities and to maintain a
constructive local challenge on behalf of patients / public, within the local community. The
creation of larger Health Service provider units, some covering more than one Local Authority
will require the maintenance of an effective local voice. It was emphasized that CHCs are
ideally placed to undertake this role and with some strengthening could provide an even more
effective challenge at both national and local levels.
Cardiff CHC recommended that:
“This re-structuring must provide the opportunity to establish a robust mechanism for the
effective planning and provision of Health (and possibly Social Care) that will be capable of
evolution over time, so that the objectives of delivering a first class Health Service to the
population can be realised.”
10
WELSH ASSEMBLY GOVERNMENT: DELIVERING THE NEW NHS FOR WALES
CONSULTATION PAPER 2
The Welsh Assembly Government (WAG) subsequently published a second consultation paper -
Delivering the New NHS for Wales. The deadline to respond was 25th February 2009. The
consultation paper provides details of the next stage in the proposed reform of the NHS in
Wales. It builds on the feedback received to the first consultation paper Proposals to Change the
Structure of the NHS in Wales published in the spring 2008.
Delivering the New NHS for Wales proposes a simplified structure for the NHS in Wales by the
dissolution of 21 LHBs - ie all LHBs in Wales, except for the Powys LHB - and the dissolution
of the 7 NHS Trusts in Wales.
In November 2008, the Minister for Health and Social Services confirmed that the new NHS
local bodies in Wales would be established as LHBs. The consultation document provides
details of the proposed model, membership and functions of the 7 LHBs. The boards will be
operational by autumn 2009.
To further develop members’ understanding of the proposals, members received a presentation
on the consultation proposals at an Extraordinary CHC Business, Training and Development
meeting on Wednesday 21st January 2009.
Cardiff Community Health Council Response to Consultation Proposals
Following the Extraordinary CHC Business, Training and Development meeting held on
Wednesday 21st January 2009, the minutes of that meeting were forwarded to the Board of CHCs
in Wales, to be included in an All-Wales CHC response.
Cardiff CHC emphasized members’ concerns in relation to:
• The role and structure of the Stakeholder Reference Group.
• The role and structure of the Professional Forum – for example, membership; links
between the Forum and the CHC are not discussed.
• Lack of any reference to CHCs in the document – fully recognising that the WAG would
be launching a further consultation on the role of CHCs in the future.
11
CARDIFF AND VALE HEALTH TRANSITION PROJECT
Following the Minister for Health and Social Services’ decision to establish the new LHBs in
Wales, Cardiff LHB, the Vale of Glamorgan LHB and Cardiff & Vale NHS Trust established the
Cardiff and Vale Health Transition Project.
The function of the Project Group is to oversee the necessary transitional arrangements to
• dissolve Cardiff LHB, the Vale of Glamorgan LHB and the Cardiff & Vale NHS Trust
• establish the Cardiff and Vale University LHB
To provide business continuity and to ensure that there is no detrimental effect to the patient
experience.
Cardiff CHC is represented on
Transition Board Chief Officer
Planning and Partnership Work-stream Dr G Briwnant-Jones
Organisational Development / Culture /
Engagement Work-stream
Mr S Allen
Mrs Jan Williams (Transition Director) attends the monthly Cardiff CHC council meetings, to
provide members with an update on the transition arrangements. For example, progress made in
relation to:
• Appointments made to the National Advisory Board (NAB) and National Delivery Group
(NDG)
• Appointments made to the Cardiff and the Vale University LHB – Chair, Vice Chair, Chief
Executive and Executive Directors posts.
• Updates on the activities undertaken by the 6 work-streams managing the transition to the
new Cardiff and Vale University LHB.
• Activities include – reviewing the provision of Unscheduled Care Services; developing an
Annual Operating Framework; reviewing the financial position of the Cardiff & Vale NHS
Trust, Vale of Glamorgan LHB and Cardiff LHB, to prepare for the dissolution of those
organisations and establishment of the New LHB.
• Identifying risks to the transitional arrangements. For example, concern was raised that the
Health Community will not achieve financial balance and the WAG waiting time targets at
the end of the financial year (31st March 2009); the New LHB will be established half way
through the financial year; the need to ensure that the Programme for Health Service
Improvement (PHSI) Project agenda continues and is not un-necessarily delayed due to the
re-structuring of the NHS.
12
WELSH ASSEMBLY GOVERNMENT: PROPOSALS ON THE FUTURE OF
COMMUNITY HEALTH COUNCILS IN WALES
The Welsh Assembly Government (WAG) undertook a 12 week public consultation on
Proposals on the Future of CHCs in Wales, which is due to close on 24th April 2009.
The consultation proposals include:
• The dissolution of the existing 19 CHCs in Wales
• Establishment of 7 new CHCs with 23 underpinning Area Associations
• Functions, structures and membership of the 7 new CHCs
• Functions, structures and membership of the Board of CHCs in Wales.
The proposals are to come into effect from 1st October 2009.
During the 12 week consultation period a series of local consultation events are scheduled to be
held. The local consultation event for Cardiff and the Vale of Glamorgan was held on Friday
20th March 2009 (2.00 pm – 5.00 pm) at County Hall, Atlantic Wharf, Cardiff.
Members received a presentation on the consultation proposals at an Extraordinary CHC
Business, Training and Development meeting on Tuesday 24th February 2009.
Dr G Briwnant-Jones, the Chief Officer and Mr S Allen represented Cardiff CHC at an All
Wales CHC Event held on Wednesday 25th March 2009 to discuss WAG public consultation
document Proposals for the Future of CHCs.
The outcome of the consultation exercise will be discussed in the Annual Report 2009-2010.
13
THE TRANSFER AND DEVELOPMENT OF CHILD AND ADOLESCENT MENTAL
HEALTH SERVICES IN SOUTH WALES
Following the Health Commission Wales (HCW) public consultation on The Transfer and
Development of Child and Adolescent Mental Health Service (CAMHS) in South Wales from
Monday 18th June 2007 to Monday 10
th September 2007, the CHC continues to closely monitor
the implementation of the CAMHS consultation proposals during 2008-2009.
A visit to Hafod Newydd was undertaken on Tuesday 15th April 2008 by members of Cardiff
CHC, Pontypridd & Rhondda CHC and Bridgend CHC. Hafod Newydd is the temporary
CAMHS inpatient Unit developed at the refurbished Caswell Clinic, Glanrhyd Hospital,
Bridgend – to accommodate the transfer of inpatient CAMHS services from the Harvey Jones
Adolescent Unit based at Whitchurch Hospital prior to the development of a permanent build at
the Princess of Wales Hospital. Cardiff CHC first visited the temporary Unit on Thursday 20th
December 2007, before the children / young people were transferred from the Harvey Jones
Adolescent Unit.
Cardiff CHC was represented by Mrs F Webster, Mr R Woodward and Dr C Kerby at the visit
held on Tuesday 15th April 2008. Whilst the Team was impressed by the environment at the
refurbished Caswell Clinic, concern was raised in relation to:
• The five emergency inpatient beds had still not been commissioned at the time of the visit.
It was noted that the lack of emergency inpatient beds has a direct impact on the
management of the Unit. For example, the building is ‘locked up’ to accommodate
emergency patients. At the time of the visit one inpatient was on a 28 day section; whilst a
second inpatient required one to one care. This issue was further highlighted at the CHC
monitoring visit to the Llanfair Unit, Llandough Hospital on Monday 14th April 2008,
where a 16 year old person had been admitted to the adult mental health Unit as Hafod
Newydd did not accept emergency admissions.
In a letter dated 31st July 2008, Edwina Hart AM MBE (Minister for Health and Social
Services) advised the CHC that an agreement had been reached with regard to the
commissioning of the emergency inpatient beds and that Cwm Taf NHS Trust and Health
Commission Wales was working towards commissioning a fully operational service in
October 2008.
Following correspondence with the Chief Executive of the Cwm Taf NHS Trust in relation
to the provision of the five emergency beds, the CHC was advised in October 2008 that the
Trust and HCW had agreed to commission 75% of the available capacity in Hafod Newydd
from December 2008 – ie 11 planned beds and 3 emergency beds, with some flexibility to
increase capacity if necessary.
• The mini-bus to be used for the children / young people to access leisure and social
facilities had not been purchased.
At the time of the visit there was some discussion taking place around which NHS Trust /
other body is responsible for the driver’s wages and the cost of the insurance for the mini-
bus. Following correspondence with the Chief Executive of the Cwm Taf NHS Trust, the
14
CHC was advised in October 2008 that the Trust is to purchase a ‘people carrier’ for
transporting clients and carers.
• Continued lack of access to Education for the 16-18 year old age group. It was recognised
that access to education is not a direct responsibility of the NHS. However, during the
public consultation exercise, it was indicated that progress had been made in this area.
• Lack of access to Social Services.
The Chief Officer met with representatives from Cwm Taf NHS Trust and Health Commission
Wales on Friday 30th January 2009 when a number of issues were discussed. A letter from Sue
Brannam (Directorate Manager, Child and Adolescent Mental Health Directorate, Cwm Taf
NHS Trust) was subsequently received which provided an overview of the discussion:
- The provision of an Emergency Assessment and Admission Service from the Hafod
Newydd commenced in December 2008. The service is staffed to provide a 24 hour
assessment and admission service, with CAMHS Band 6 nurse available to go out
and undertake joint assessments with an On-Call Consultant Psychiatrist on a 24 hour,
7 day a week basis.
- An order had been placed for a people carrier type vehicle for the Unit.
- The Unit’s teacher transferred with the service following the transfer of inpatient
services from the Harvey Jones Adolescent Unit, based at Whitchurch Hospital. The
teacher is now employed by the Bridgend Education Department.
- The Hafod Newydd does not have a dedicated, funded Social Worker post. However,
the staff make every effort to link with the social services department in the patient’s
home area to ensure appropriate care and support. It is clear that a social workers
attached to the inpatient service would enhance the provision of care to young people.
The Trust is continuing to work with colleagues in the WAG and Local Authority
Social Services Department in seeking a solution to this issue.
15
PROGRAMME FOR HEALTH SERVICE IMPROVEMENT PROJECT IN CARDIFF
AND THE VALE OF GLAMORGAN
As discussed in last year’s Annual Report (2007-2008), the Cardiff and Vale of Glamorgan
Health Community is continuing to develop its response to the WAG document ‘Designed for
Life’, a 10 year vision for creating world class health and social care in Wales in the 21st century.
The response is the Programme for Health Service Improvement (PHSI) Project in Cardiff
and the Vale of Glamorgan and is led by Cardiff LHB (the commissioners of health services in
Cardiff), Vale of Glamorgan LHB (the commissioners of health services in the Vale), the Cardiff
& Vale NHS Trust and other NHS organisations.
It was previously envisaged that a range of health service provision changes would be consulted
upon in (approximately) autumn 2008 and would encompass, for example:
• The introduction of new patient pathways and models of care that would affect the
University Hospital of Wales, Llandough Hospital, St David's Hospital, Rookwood
Hospital and West Wing, Cardiff Royal Infirmary.
• The development of Locality Resource and Treatment Centres across Cardiff - providing
GP care, diagnostic services, minor injury services, etc. These centres would enable a GP
to refer a patient to a Centre for an x-ray or physiotherapy rather than the University
Hospital of Wales or Llandough Hospital.
However, the public consultation has been delayed. Nevertheless, the CHC continues to be
involved in the pre-consultation process.
As reported in previous Annual Reports, Cardiff CHC established a ‘Designed for Life’ Group in
2005-2006:
• To enable the CHC to fully participate in the Designed for Life / PHSI Project. The CHC
is represented on the various groups of the PHSI Project. Therefore, CHC members are
kept appraised of all current developments. Members of the CHC Designed for Life
Group also attend the Clinical Services Project Board and Planning Groups [a full list of
CHC representation on internal and external groups is available from the CHC office].
This involvement in the early planning stages of the consultation is especially important
for the CHC, as it allows the CHC to fully understand the implications of a complicated
re-design of Health Services in Cardiff.
• To actively engage the public in the pre-consultation stage – for example, with
presentations to the CHC Public Reference Group members.
As well as holding regular CHC ‘Designed for Life’ Group meetings and attending the PHSI
Project Sub-Groups, CHC members have also:
� Received presentations on the PHSI Project. For example, the Director of Service
Planning (Cardiff & Vale NHS Trust) attended:
o CHC Business, Training and Development meeting held on Tuesday 1st July
2008 to provide members with a presentation on the PHSI Project.
o Carers Group meetings at Turnbull Day Hospital, St David's Hospital held on
Thursday 1st July 2008 and Thursday 27th November 2008 – to update and
16
engage with carers of patients in the Cardiff & Vale NHS Trust Mental Health
Services for Older People (MHSOP) Directorate on the PHSI Project in relation to
MHSOP.
� Attended stakeholder events
o Options Appraisal Event – Thursday 17th July 2008, Sports and Social Club,
University Hospital of Wales
o CHC Modernisation Briefing Meeting, Continuous Improvement v Substantial
Development – Monday 3rd November 2008, The Presidents Room, Sports and
Social Club, University Hospital of Wales
o Citizen’s Jury on the Future Development of Stroke Services – November 2008,
City Hall, Cardiff
17
MONITORING VISITS UNDERTAKEN DURING 2008 - 2009
As part of its statutory rights and duties Cardiff CHC members undertake a programme of
monitoring visits to the three NHS Trusts (Cardiff & Vale NHS Trust, Velindre NHS Trust and
the Welsh Ambulance Services NHS Trust) and Primary Care General Practices covering the
Cardiff area.
The CHC is also working towards developing monitoring visit protocols for visits to Community
Pharmacy, Dental Practices and Nursing Homes.
The monitoring visit leads or visit co-ordinators are members of the CHC. Their role is to lead
the visit and produce a report on that visit. To help the members undertake these monitoring
visits, they are provided with monitoring visits guidance produced by the CHC.
Prior to a visit to the hospital or General Practice, the CHC normally receives briefing papers –
to enable the members to have an overview of the area that they are to visit, including the
services provided, staffing levels, information on achievements and developments.
The reports and responses are published in the monthly CHC council papers and are available to
members of the public.
Copies of the briefing papers, CHC report and NHS Trust’s or General Practice’s response
to the visit can also be obtained from the CHC office or the website.
www.patienthelp.wales.nhs.uk/cardiff
18
PRIMARY CARE SERVICES REPORT
Cardiff CHC continues to actively monitor Primary Care Services provided by the NHS as
detailed below.
General Practice
Cardiff CHC completed its 3 year programme to visit all GP practices within Cardiff. Under the
mechanism called Quality Outcomes Framework (QOF) GP Practices undertake an annual
patient survey. Cardiff LHB approved the CHC as its authorised patient group. The CHC
undertook the independent review of 53 General Practice results and associated action plans
which identify 2 areas of improvement for the forthcoming 2 year period. This review led to a
number of Practices amending their action plans following the review by the CHC.
The CHC was actively involved with the LHB in their Primary Care Estates planning group
which reviews the planning process for new or replacement GP Practices across the city.
Nursing Homes
Cardiff CHC in partnership with 2 Regulators - Care & Social Standards Inspectorate Wales
(CSSIW) and Cardiff Local Authority Nursing Home Inspection Unit, South Glamorgan Matrons
Forum - has developed a visiting model to be undertaken by the CHC.
This partnership has been established to ensure the CHC visits to Nursing Homes under the
CHCs statutory duty does not duplicate the work of the Regulators who visit Nursing and
Residential homes. Following discussions we have developed a service user / carer
questionnaire which when completed can be fed back to the Nursing Home, CSSIW and Local
Authority inspectorates giving a service user / carer view.
We will be piloting the visiting model and questionnaire mid-2009, with visits being arranged
from late 2009 onwards.
Dental
Cardiff CHC monitors Dental Services through the Dental Reference Service reports. These
reports are received and discussed by the CHC Primary Care Group. Visits are arranged as
required.
Professional Networks
The CHC continues to maintain effective working relationships with the Local Medical
Committee, Community Pharmacy Wales, British Dental Association, Dental Reference Agency
and the South East Wales Regional Ophthalmic Committee.
19
NHS TRUST MONITORING VISITS
In the last year, Cardiff CHC has undertaken a varied programme of visits to the NHS Trusts.
Date Area of Visit
Hospital / Service Group
2nd April 2008
Ward B 7 - Short Stay Acute General
Medical Ward specialising in Diabetes
and Endocrinology
University Hospital of
Wales
14th April 2008 Llanfair Mental Health Unit
Llandough Hospital
18th April 2008 Hospital Patient Environment Exercise –
Follow Up Visit
University Hospital of
Wales
25th April 2008 Hospital Patient Environment Exercise –
Follow Up Visit
Velindre Cancer Centre
(Velindre Hospital)
23rd May 2008
Cancer Care Cymru, Atlantic House
Cardiff Gate Business Park
Cancer Services
14th July 2008 Informal Fact Finding Visit to Referral
Management Centre, Vale of Glamorgan
Local Health Board
Cancer Services
21st July 2008
Dermatology Services based at Glamorgan
House
University Hospital of
Wales
27th August 2008
Haematology / Bone Marrow Unit
University Hospital of
Wales
12th September 2008 Ward C 1 – Maternity Services
University Hospital of
Wales
19th September 2008 Ward East 1- Upgraded Adult Mental
Health Service Ward
Whitchurch Hospital
29th October 2008 Hospital Patient Environment Exercise
Velindre Cancer Centre
(Velindre Hospital)
30th October 2008 Hospital Patient Environment Exercise
University Hospital of
Wales
7th November 2008 Fact Finding Visit to the Shire Hall Care
Home
Dumballs Road
Cardiff Bay
10th November 2008 Butetown Dental Clinic
Butetown Health Centre
Dental Services
13th November 2008 Ward C 7, Co-located Stroke Beds, Stroke
Services
University Hospital of
Wales
21st November 2008 Gofal Cymru: Cardiff Community Crisis
House
15-17 Park Road,
Whitchurch, Cardiff
26th November 2008 Anwen and Delyth Wards, Breast Care
Services
Llandough Hospital.
29th January 2009 Gynaecology Oncology Inpatient and
Outpatient Service And Midwifery Led
Unit
Llandough Hospital
9th February 2009 Unannounced Visit to Short Stay Surgical
Unit
University Hospital of
Wales
20th February 2009 Patient Experience Questionnaire –
Facilities, Wards 4 and 5
Rookwood Hospital
20
24th February 2009 Unannounced Visit to the Iorwerth Jones
Unit
Trenchard Drive Llanishen,
Cardiff
5th March 2009 Glan Ely Ward and Royal Hamadryad
Ward, Mental Health Services
For Older People (MHSOP) wards
St David's Hospital
23rd March 2009
Sky Ward, Children’s Cancer Ward,
Children’s Hospital for
Wales, Heath Park site
27th March 2009 Paediatric Accident & Emergency Unit
University Hospital of
Wales
As discussed in previous Annual Reports, monitoring visits focus on issues that are relevant to
patients and members of the public. For example:
• Hospital Environment – Hygiene and cleanliness in hospitals.
• Catering Services.
• Hospital Acquired Infection and Infection control – MRSA, Norovirus, Clostridium
Difficile.
• Delayed Transfers of Care (DTOC) - also referred to in the media as ‘bed blocking’.
• Postponed treatment and surgery due to DTOCs.
• Waiting Times.
• Issues of dignity and privacy.
• Patient experience of the services that they have received.
Environment
To help develop the CHC’s role in monitoring and evaluating the hospital environment, the
Cardiff CHC Facilities Services Team was established at the Annual General Meeting held on
Tuesday 13th May 2008. The Team met with Cardiff & Vale NHS Trust representatives on
Thursday 11th September 2008 to receive a presentation and have a discussion on:
• Ward Environment – the Trust’s de-clutter programme; improvements being made with
stock control; upgrading of wards (for example, C2 and A3 at the University Hospital of
Wales)
• Infection Prevention and Control issues – the aims of the Team; reporting structures; key
areas of work
• Cleaning Services – cleaning specification; monitoring of standards; staffing levels and
training.
The Team has also developed a Patient Experience questionnaire, to obtain the patient’s views
on the ward environment, cleanliness and hygiene. This was piloted on a visit to Wards 4 and 5
at Rookwood Hospital (Friday 20th February 2009).
In all monitoring visits, members consider the overall décor as part of the whole patient
experience. The need for maintenance or refurbishment work is frequently commented on in the
visit reports. For example, during the CHC’s visit to the Butetown Dental Clinic, the Team was
pleased to note that the Clinic was clean and bright. However, concern was raised in relation to
lack of disabled access. The Clinic is situated on the 1st Floor and accessed by a stairway, there
is no lift available. It was noted that new facilities are due to be developed in Butetown, which
will address this issue.
21
CHCs in Wales continue to undertake an annual Hospital Patient Environment (HPE) exercise -
to provide an overview of the environment within District General Hospitals and Community
Hospitals. A ‘tick box’ style assessment form is used to evaluate the external areas, entrances
and main reception areas, common areas, ward areas, departments. An area is rated as poor, fair,
good, or excellent. Depending on the assessment form, the areas considered include – toilet
facilities; signage; car parking; tidiness; staff (availability, appearance); privacy and dignity;
provision of linen. Follow-up HPE visits are also held approximately 6 months later – to
evaluate progress made in relation to areas identified as requiring further attention.
Cardiff CHC undertook HPE visits to the Velindre Hospital (Wednesday 29th October 2008) and
University Hospital of Wales (Thursday 30th October 2008). The visits identified:
• Storage problems. This is an ongoing issue for many NHS Trusts.
• Need for maintenance work or refurbishment to be undertaken – For example, Ward C 2,
University Hospital of Wales.
• Signage. For example from the multi storey car park to the Main Concourse, University
Hospital of Wales. To access the Linear Accelerators at the Velindre Hospital.
• The need to ensure that all staff wear visible identity badges. This was observed during
both HPE visits.
The ‘Follow Up’ visits are due to be held in April 2009.
Catering Services
CHC monitoring visits have highlighted patients’ concerns about the Catering Service provided
in hospital.
During the visit to the Breast Care Wards at Llandough Hospital, a patient commented on the
lack of vegetarian options available at each meal. The Trust response stated that if a patient is
unhappy with the menu, the ward staff would contact the Catering Supervisor to offer an
alternative.
At the time of the CHC’s visit to Ward B 7, members were advised that there was no protected
meal time. The Trust response states that protected meal time has been considered, however, on
balance, given the current case mix, the support of family members assisting at meal times is
most appreciated by the patient, their family and the clinical teams. (The majority of patients on
the ward are 65+ years.)
Concerns with the Catering Service have been highlighted via the Carers Group meetings held on
a bi-monthly basis at the Turnbull Day Hospital, St David's Hospital and the Iorwerth Jones
Centre. These meetings are for carers of patients within the Mental Health Services for Older
People (MHSOP) directorate at the Cardiff & Vale NHS Trust. The minutes of these meetings
are available on the CHC website, hardcopies can also be obtained from the CHC office. At the
Carers Group meeting on Thursday 27th November 2008, carers of patients at the Iorwerth Jones
Centre discussed problems with the Catering Service following the transfer of the wards East 2,
West 2 and East 4, Whitchurch Hospital to the Iorwerth Jones Centre in October 2008:
- Meals that are under or over cooked
- Limited variety in the menu.
22
- Inadequate meal sizes
The CHC also attended the Cardiff & Vale NHS Trust Nutrition and Catering Steering Group,
where it had the opportunity to represent the views of the patient / public. The Group was
disbanded by the Trust in February 2009 and is due to be replaced by a new Strategy Group and
associated Task and Finish Groups. The CHC has been advised that it will be invited to join the
Task and Finish Groups in due course (memo dated 16th February 2009, from Sue Gregory,
Nurse Director, Cardiff & Vale NHS Trust).
Delayed Transfer of Care – Postponed Elective Treatment and Surgery
As discussed in previous Annual Reports, Delayed Transfer of Care (DTOC) cases occur when a
patient is ready to be discharged from the hospital to their own home or residential / nursing
home. However, they are unable to be discharged as:
• A care package is being developed by the Local Authority / NHS for the patient to return to
their own home / nursing or residential home.
• Arrangements are being made for them to be admitted to a residential / nursing home.
There may be some delay if there are no suitable vacancies in the area.
DTOCs tend to be associated with older people but this is not always the case.
A reduction in inpatient bed availability can lead to:
� Elective (planned) treatment and surgery being cancelled.
� Delays in the Accident & Emergency Unit. For example, increased dependence on trolley
beds due to lack of inpatient bed availability; delays for ambulance staff admitting patients.
� Delays in the ‘patient pathway’ from admission to discharge.
� Increased exposure to a hospital acquired infection for the person who is a DTOC case.
� Patients who are admitted to a ward or unit not normally associated with their specific
health needs or treatment are often referred to as ‘outliers’, ie they are on a ward that they
would not normally be admitted to.
The issue of DTOCs is therefore an important consideration for the CHC and continues to be
closely monitored via:
• The Cardiff & Vale NHS Trust monthly Performance Report and Exception Report on
Performance Issues - which are regularly discussed at the CHC council meetings.
• The CHC is represented on the Cardiff Local Service Board Scrutiny and Performance
Project and the Scrutiny, Performance and Accountability Group - which keep under
review progress made in relation to DTOCs.
• And, of course, monitoring visits.
The CHC’s visit to Ward C 7, University Hospital of Wales, highlighted that there is no
designated social worker for the ward and the allocation of a social worker to a patient can take
up to 14 days or longer. In the Cardiff & Vale NHS Trust response to the visit, the Trust advised
the CHC that the Trust has had two additional qualified social workers and a Discharge Liaison
Nurse working together across the 7th Floor to try to both improve quality and speed of
23
discharge. The Trust funded the 2 Social Worker posts with the aims of integrating and
embedding a unified health and social care pathway. Although the allocation of a social worker
can take up to 14 days or longer, all patients are reviewed by a ‘contact officer’ within 1 working
day. The contact officer collects preliminary information to support the social worker in their
assessment.
Highlighting Other Areas of Concern
Monitoring visits can also help to highlight other areas that need to be addressed – equipment,
improved signage, waiting times to access health services, funding issues etc.
For example:
The CHC’s visit to the Haematology / Bone Marrow Unit at the University Hospital of Wales
highlighted a number of issues.
• Patient transport issues. Patients commented on their experience of car parking and / or
using public transport.
Car parking - finding a parking space, the cost of parking at the University Hospital of
Wales, distance involved walking from the car to the hospital.
Public transport - distance walking from the bus stop to the Unit and the cost of fares.
The cost of travelling was especially significant where patients attend the Clinic on a
regular basis.
• Inadequate level of inpatient beds for the service. The Trust response states that "Based on
current levels of occupancy, the bed provision for the Directorate is sufficient to meet
current demands".
• No dedicated Bronchoscopy Service at the University Hospital of Wales. The Trust agrees
that the Bronchoscopy service for the tertiary specialities is limited and requires a business
case to secure commissioner support for the revenue and infrastructure costs.
• Need to update Outpatient facilities and expand Day Unit. The Trust response to the visit
and report indicates that the Directorate is "acutely aware of the limitations of the existing
Day Unit Facility, and thank the CHC for acknowledging this fact. Demand has increased
exponentially in recent years and the facility is straining to cope with the additional
demand, both in terms of staffing and the structural environment". The response continues
that the Directorate is continuing to work with the Service Group Management Team and
Trust accommodation committee to explore alternative solutions.
The visit to Ward C 7, University Hospital of Wales, highlighted some improvements to the
service.
• Cheerful and caring staff
• Goal Planning Meetings at admission – to plan for the patient’s discharge
• Dietetic Assistant available during the week
However, concern was raised in relation to:
24
• Lack of Physiotherapy and Occupational Therapy available at the weekends and on Bank
Holidays which can have a detrimental effect on the patient’s overall recovery.
• No dedicated Social Worker on the ward, which can affect the patient’s discharge
arrangements and result in Delayed Transfer of Care (DTOC) cases, although there is bed
capacity in nursing and residential homes [as discussed above]
• Accessing Phlebotomy Services and long waits in the Outpatients Department, when
procedures could be undertaken in the patient’s own GP Practice. The Trust response
states that the issue has arisen as a consequence of the GMS contract. The Trust has no
influence over this particular issue and would agree that the service could be provided
locally to the patient.
The CHC visited Ward C1, Maternity Services, University Hospital of Wales:
• To receive a brief overview of the Maternity Service
• To conduct a Patient Satisfaction Survey of the patient experience of the antenatal, intra-
partum and post-natal stages.
• To keep under review the implementation of major service developments previously
consulted upon - ie The Development of Cardiff & Vale NHS Trust Services for Women
and Babies, or the Women's Services Review, Public Consultation undertaken in 2005.
The CHC Team noted:
• Increase in birth rate in Cardiff and Vale of Glamorgan area.
• Staff training is on-going, despite the present pressures the Unit is under.
• Some midwives are now training to undertake newborn examinations, which will help to
speed up the discharge process for the women and babies.
• Breast feeding classes are on-going on the ward and after discharge of the patient.
• The ward is light and airy - although it was acknowledged that the environment was not
designed as a Maternity Ward, therefore that are issues around space available to
accommodate cots and personal belongings.
• Security on the ward is paramount. The team was advised that the main doors to the
ward are locked at all times.
• Handwashing facilities are available with appropriate notices.
• From a limited survey of 22 women, the survey results indicate that there is general
satisfaction with the Maternity Service. However, patients did raise concern in relation to
- contact with Community Midwife; choice of birthing options; access to Parenting
Classes; continuity of care during the pregnancy and labour; transfer arrangements from
the Midwifery Led Unit to the Obstetrics Unit.
The Trust response advises the CHC that:
• Since the CHC visit, 10 newly qualified midwives have been employed to fill vacant
posts and the Directorate is advertising for additional Maternity Care Assistants and
Nursery Nurses.
• The first Obstetric ALERT course has run and evaluated very well. This is a
multidisciplinary course which will educate staff to recognise and manage the critically
ill woman. More midwives will undertake the Examination of the Newborn course in
2009.
• A Breast Feeding Co-ordinator has been appointed
25
• The lack of bed tables for women to use at meal times has been noted by management
and was discussed. Costings are being obtained with a view to securing funding to
purchase these items.
• The survey undertaken by the CHC has provided "valuable information on the patient
experience ..., even though the sample was limited to 22 women. The findings will be
helpful as we review all areas of the service".
Fact Finding Visits enable members to obtain an overview of a particular service provided by
the NHS.
• Shire Hall Care Home - as part of an awareness raising process on alternative Continuing
NHS Health Care accommodation availability within the Community.
• Gofal Cymru: Cardiff Community Crisis House – as part of the CHC Mental Health
Team’s evaluation of the Cardiff Crisis Service Model. The Crisis House provides care
and treatment to patients with a mental health illness who would otherwise be admitted to a
Mental Health hospital - for example, Whitchurch Hospital or the Llanfair Mental Health
Unit.
The Visiting Team was pleased to note
- the high level of enthusiasm of the staff for the project
- flexible treatment provided, depending on the patient’s needs
- quality time spent with the client to uncover issues of concern and provide the
appropriate help and support
- homely surroundings of the facility
Concern was raised in relation to the fact that the Big Lottery funding used to provide this
service is due to cease in June 2009. This issue was discussed at the CHC council meeting
held on Tuesday 20th January 2009, when members were advised that the Crisis House is
core to the development of Mental Health Services in Cardiff. Cardiff LHB has given its
assurance that funding for the service will be made available to ensure that the facility
continues.
26
CARDIFF COMMUNITY HEALTH COUNCIL MENTAL HEALTH SERVICES TEAM
The work of the CHC Mental Health Services Team (established in 2006-2007) continues to
develop. The Team has been expanded to include Learning Disability Services.
Members of the Team represent the CHC on various Mental Health Services and Learning
Disability Services Advisory Planning Groups (APGs) and Joint Operational Groups (JOGs)
across the Cardiff & Vale NHS Trust and Cardiff LHB.
The CHC Mental Health Services Team meets on a regular basis to:
• Share information and developments made within Mental Health Services.
• Receive appropriate presentations, to further develop their knowledge and understanding of
Mental Health Services in Cardiff and better represent the views and health needs of the
patient / public.
Thursday 24th April 2008 Presentation on the current and future role of Community
Mental Health Teams - Martin Ford (Senior Nurse Manager,
Community Mental Health Services, Cardiff & Vale NHS
Trust)
Thursday 22nd January 2009 Presentation on the Mental Health Act - Julia Barrell (Mental
Health Act Implementation Manager, Cardiff & Vale NHS
Trust)
During 2008-2009, the CHC Mental Health Team has continued to focus on the implementation
of the proposals agreed in the Mental Health Services Public Consultation (2002) undertaking a
series of visits to ensure that the proposals are being implemented in a consistent manner.
• Llanfair Mental Health Unit, Llandough Hospital – The CHC last visited this Unit on
24th October 2006.
• Ward East 1, Whitchurch Hospital. The Team was pleased to observe that the ward has
been transferred to a refurbished environment on the Ground Floor. The additional space
has enabled the Trust to provide separate male and female areas and meet their dignity and
privacy needs. It allows people to find quiet areas if they need it; and company and
stimulation at other times. The clients on the ward gave some positive feedback on the
level of care on the ward from the staff. The Team did note a number of DTOCs cases on
the ward. The Trust response confirms that a number of clients were waiting for
alternative placements in the Community. Subsequent to the visit, Cardiff LHB approved a
number of suitable placements, to enable those clients to be discharged and transferred to
appropriate community placements.
• Unannounced Visit to the Iorwerth Jones Centre.
And as noted above, fact finding visits to the Shire Hall Care Home and the Cardiff
Community Crisis House were also undertaken during the year.
The CHC Mental Health Team will undertake its programme of visits to Learning Disability
Services in 2009-2010
27
CARDIFF COMMUNITY HEALTH COUNCIL CANCER SERVICES TEAM
As detailed in the Cardiff CHC Annual Report 2007-2008, the CHC Cancer Services Team was
established in May 2007, to monitor the provision of Cancer Services in Cardiff. The CHC
Cancer Services Team commenced its 2007-2008 monitoring programme with visits to:
• Referral Management Centre, based at the Vale of Glamorgan LHB
• Medical Records Unit, University Hospital of Wales
• Ward C 2, University Hospital of Wales
In 2008-2009, the CHC Cancer Services Team has continued to develop its understanding and
knowledge of Cancer Services.
The Team met on a regular basis to discuss Cancer Services and to receive appropriate
presentations:
Wednesday 4th June 2008 Presentation on the role of the South East Wales Cancer
Network and impact of regional commissioning on their
activity – Mr Hywel Morgan (Manager, South East Wales
Cancer Network
Friday 26th September 2008 Discussion on Cancer Services provided by the Cardiff & Vale
NHS Trust - Mrs Maggie Lucas, Cancer Services Senior
Manager, Cardiff & Vale NHS Trust)
Friday 5th December 2008 Overview of the role and services provided by the Maggie’s
Centre – Mrs Debbie Horrigan, Maggie’s Centre, located at
Singleton Hospital, Swansea
The Team has continued its programme of fact finding and monitoring visits. For example:
• Fact Finding Visit to Cancer Care Cymru – to receive an overview of the work of that
organisation; its impact on hospital waiting lists; services provided to meet the needs of the
patient and family
The Visiting Team was pleased to be advised that the service has had a positive impact on
hospital waiting lists due to prompt and timely assessment of patients and the availability
of enhanced care with complementary treatment. Cancer Care Cymru has led the initiative
in protective meal times at the Velindre NHS Trust over the last 18 months. It provides
timely bereavement support. Nurses work alongside Consultants in developing specific
care and support, individualised to meet the needs of the patient.
• Breast Cancer Care Services, Llandough Hospital – The purpose of this visit was to
monitor the patient experience and management pathway prior to and following breast
cancer surgery; to consider the availability and accessibility of services for patients with
breast cancer prior to transfer to the Velindre Hospital.
The Team was pleased to note the development of the role of Breast Care Nurses who
cover both the Llandough Hospital and University Hospital of Wales sites, providing
clinical as well as emotional support to the patient and their family, as appropriate. The
Team recommended the need for the Trust to recruit a clerical / administrative assistant to
support the increasing work of the Breast Care Nurses. However, the Trust advised the
28
CHC that there is no funding for this post at the present time or the foreseeable future. The
Trust has purchased some additional computers and telephone lines, which will help the
nurses in the interim period.
Members of the Team also attend meetings, seminars and conferences on Cancer Services – with
the Velindre NHS Trust, Cardiff & Vale NHS Trust, etc. Some events are listed under
EXAMPLES OF ATTENDANCE AT CONFERENCES / SEMINARS / LECTURES.
29
PUBLIC AND PATIENT INVOLVEMENT (PPI)
‘Public and patient involvement (PPI) in the NHS has become an increasingly important priority
for the NHS in Wales, as it has in all parts of the UK. In order to achieve patient-focused care,
effective clinical governance and better accountability to individuals and communities, there is a
recognized need to involve and engage patient and the wider public more fully and meaningfully
that has been the case in the past.’
Signposts 2 - Putting Public and Patient Involvement into Practice, OPM
‘The Health Minister for Wales, Edwina Hart, unveiled new plans to improve engagement and
consultation with local people and health professionals by the NHS on any proposed changes
(October 14, 2008). The interim guidance, which will be in place until new guidance is
developed when the NHS is reorganised, places a greater emphasis on better explaining why
changes are needed, what services will be put in place and how it will improve patient care.
It makes clear that organisations should undertake continuous engagement with the public rather
than limited consultation on specific proposals. NHS Trusts and Local Health Boards will be
expected to engage in discussion about why change is needed.’ Health of Wales Information
Service
The core function of the CHC is to
• Represent the views of the public within the NHS
• Ensure that local health care needs are recognised
• Raise public awareness of NHS issues
• Ensure that local views and needs influence the policies and plans of LHB and NHS Trusts
This is achieved by:
• Developing the role of Public Reference Groups
• Promoting public awareness of the CHC and CHC Advocacy Service – to enable people to
have a say in their NHS. This is undertaken via
- CHC Exhibition Stands
- Articles in newsletters / press
- Attendance at public meetings
- Presentations to various voluntary and other groups
- Carers Group meetings. For example, for carers of patients within Mental Health
Services for Older People (MHSOP) Directorate at the Cardiff & Vale NHS Trust.
Public Reference Groups 2008 – 2009
As discussed in previous Annual Reports, the Cardiff CHC Public Reference Group (PRG)
consist of local people who are able to help plan and influence the development of Health
Services - initially within their own locality area and subsequently on a Cardiff wide basis. This
work also helps to inform CHC members whose statutory responsibility includes engaging with
and listening to the voices of local people on health issues.
30
The 4 locality PRGs (facilitated by Cardiff CHC) work collaboratively with the LHB, Cardiff &
Vale NHS Trust, Velindre NHS Trust and Communities 1st Partnership to gain the public’s
viewpoint on current and future NHS provision.
Membership of the Public Reference Group
Total Members of the Public on the PRG 185
Total CHC Members 27 (23 as of 31st March 2009)
Members of the PRG were recruited via posters / notices displayed in numerous locations
throughout Primary and Secondary Care and Leisure Facilities. Recruitment is also undertaken
by:
• Informing complainants who have used the CHC Advocacy Service of the PRG - stressing
how important their views are.
• Advising members of the public of the PRG – for example, if they are interested in joining
the CHC council. The PRG provides an excellent way to recruit new CHC members.
• Existing PRG members are also asked to bring along friends and neighbours.
There has been a slight increase in numbers this year and it is hoped to undertake further
promotion to recruit new members.
Public Reference Group Meetings and Workshops / Focus Groups Attended:
Date Public Reference Group Agenda Items
5th February 2008
Cardiff - West, Central and
North Groups
The National Unscheduled Care
Integration Project
11th February 2008
Cardiff South – Butetown
Loudoun Square Regeneration Project
Update
28th April 2008
Cardiff South – Butetown
Program for Health Service
Improvement (PHSI) Project
Pre-Consultation Update
6th May 2008
Cardiff - West, Central and
North Groups
PHSI Project Pre-Consultation Update
27th May 2008 All Groups Local Consultation Event - Proposals
to Change the Structure of the NHS in
Wales
7th July 2008
Focus Group
Private Patient Funding - National
Collaborating Centre for Cancer
8th September 2008
Cardiff - West, Central and
North Groups
Presentation – Clinical Director,
Unscheduled Care Directorate &
Consultant in Emergency Medicine
22nd September 2008
Cardiff South – Butetown
Loudoun Square Regeneration Project
Update
27 October 2008 All Groups Public Consultation Event – Presumed
Consent On Organ Donation
31
Date Public Reference Group Agenda Items
11th November 2008
All Groups
Open Evening at South East Wales
Breast Screening Centre
1st December 2008 Focus Group Improving Quality of Care – The
Patients Role. Cancer and
Cardiovascular Disease. Facilitated by
the Welsh Institute for Health and
Social Care
8th December 2008
All Groups
Presentation – Wales Air Ambulance
Service
19th January 2008
Cardiff South – Butetown Out of Hours Service
Rhondda Cynon Taff Teaching LHB
4 February 2008
Cardiff - West, Central, North
Groups
Out of Hours Service
Rhondda Cynon Taff Teaching LHB
Presentations will be arranged for future PRG meetings on a range of issues, including:
• Loudoun Square Redevelopment. There are encouraging overtures that the activity of the
Cardiff South Butetown Group will play a significant role in the development of Health
Services in the Butetown area and in the planning around the Loudoun Square
Regeneration Project. [Butetown Health Centre developments are discussed below]
• Care and Social Services Inspectorate Wales
• Community Services
Promotional Activities
Cardiff CHC and the CHC Advocacy Service for Cardiff and the Vale of Glamorgan participate
in various promotional activities – to advertise the role of the CHC, Advocacy Service and
PRGs. For example:
May 2008 Chaired GP Practice Patient Group Meeting - Whitchurch Village
Practice
12th June 2008 CHC Awareness Day – Exhibition Stand, in Main Concourse,
University Hospital of Wales
2nd July 2008 Presentation on the Role of CHC and Advocacy Service to Age
Concern Advocacy Service
8th July 2008 Voluntary Service Compact Meeting County Hall
2nd August – 9
th August
2008 (inclusive)
Exhibition Stand at the National Eisteddfod, Cardiff
Summer 2008 Article on Cardiff CHC and Advocacy Service published in ‘Ely
Grapevine’ newsletter. Free community newsletter
19th November 2008 Meeting with Stonewall Cymru
Winter 2008 Article on Cardiff CHC in ‘Grange Community News’ newsletter.
Published by Grangetown Community Concern
32
4th February 2009 Presentation on the Role of CHC and Advocacy Service to Diabetes
UK Cymru, held at Bethel Whitchurch Community Hall
9th February 2009 Presentation on the Role of CHC and Advocacy Service to Lisvane
Community Council
23rd February 2009 Presentation on the Role of CHC and Advocacy Service to The
Association of Medical Secretaries, Practice Managers,
Administrators and Receptionists (AMSPAR) Students, Barry
College
25th February 2009 Presentation on the Role of CHC and Advocacy Service to RCN
Clinical Leadership Programme Facilitators, Cardiff & Vale NHS
Trust
South East Wales Public and Patient Involvement (PPI) Network Group
Cardiff CHC is actively involved in the Welsh Assembly Regional PPI Network whose
membership involves statutory, voluntary, local authority and lay members. This group is
co-ordinated by the Patient Experience Team based in the Assembly.
Community Health Council and Communities 1st Partnership
A meeting was held (8th May 2008) to discuss strengthening the links between the CHC and
Communities 1st - how the two organizations could best use their resources, to facilitate public
consultation in the future, to highlight health issues to their communities. A number of
suggestions were made:
• CHC could attend Communities 1st group meetings and / or staff meetings.
• Social Functions in Splott could be used – for example, road shows; an exhibition stand on
market day.
• Articles in Communities 1st newsletters – for example, to raise awareness of the CHC,
health issues, consultation proposals.
• CHC to keep Communities First up to date on health issues – advise on health issues via
email / letter, for information to be circulated throughout the organization to the public.
At the meeting it was agreed that the CHC would keep Communities 1st informed on health
issues on an on-going basis – and not just to tap into the organization when the views of the
public are required for consultation, etc. The process needs to be mutually beneficial.
Butetown Health Centre
The regular PRG meetings held in Butetown have raised issues concerning accessing health care
and service provision in the Butetown Health Centre. Working jointly with the Cardiff and Vale
NHS Trust, significant refurbishment has taken place to improve the environment at the Health
Centre. Funding was limited for the refurbishment due to the planned new health centre and the
work was carried out in phased stages. Refurbishment of the Butetown Health Centre:
Phase 1 – completed
33
• Extend number of clinical rooms in Dr Saunders practice to enable extra GP services to be
commissioned
• Part refurbishment of some rooms within Dr Saunders Practice area – but no work to
waiting area.
• Creation of a new central reception area and employment of a full time Health Centre
receptionist, this was in response to concerns raised by patients and residents of drug
related problems and people hanging around outside. It was hoped that the central location
of the reception and presence of the receptionist would deter these practices.
• Provide refurbished accommodation for the Sickle Cell Service
Phase 2 – completed
• Handrail fitted to stairs
• Roller shutter fitted to front entrance
• Modernisation to left hand side of building to include Dr Singh and Dr Tiwari’s waiting
area - new carpets, lighting, blinds, furniture and notice boards
• Disability Discrimination Act (DDA) compliant toilets
Phase 3 – to be arranged
• Upgrading of Dr Singh and Dr Tiwari’s clinical rooms - to include new flooring, blinds,
redecoration, etc
• Possible upgrading of Dr Singh’s reception area
• Exterior of building
• New signage – part completed
• CCTV
• When all work is completed a deep clean of the Health Centre would take place.
The CHC has ensured that local people have the opportunity to receive updates from the Cardiff
Community Housing Association, the Local Authority and Cardiff LHB in relation to the
progress of the redevelopment of Loudoun Square and the new Butetown Health Centre.
Members of the PRGs have also had the opportunity to raise questions on the proposed plans.
Carers Group Meetings
As noted under Monitoring Visits, the CHC facilitates Carers Group meetings held on a
bi-monthly basis at the Turnbull Day Hospital, St David's Hospital and the Iorwerth Jones
Centre. These meetings are for carers of patients within the Mental Health Services for Older
People (MHSOP) directorate at the Cardiff & Vale NHS Trust.
The Groups were established to provide carers with the opportunity to have a constructive
dialogue with the Trust representatives - to pursue any issues of concern in a confidential setting.
Discussions have been held around:
• Catering Services
• Patient Laundry Service
• General maintenance and estate issues – for example, maintenance of the garden
• Staffing levels
• Access to Physiotherapy Services, etc.
34
Miscellaneous Activity
• Consultation & Engagement forum (Ask Cardiff Project) 6th November 2008
• Attendance at Cymroth Cymru Workshop 8th October 2008
• Meetings held with Stroke Association on the work of the CHC and Advocacy Service
• Production of bi monthly Newsletter “Health Watch” - distributed by email / post to all
members of CHC, Public Reference Groups, NHS Bodies, Local Authority Citizens Panel,
Community Councils, Voluntary Organisations, GP Practices and also published on the
CHC website.
Relationships Between Stakeholders
It is encouraging that LHB and NHS Trust staff feel that the CHC PRGs are a valuable resource
and are available to be accessed prior to consultation periods to highlight issues and give details
on forthcoming strategies - such as the Designed for Life Plan and the Programme for Health
Service Improvement (PHSI) project, Organ Donation (presumed consent) and NHS Re-
structuring.
The Reference Groups received an invitation from the Velindre NHS Trust to attend a Bowel
screening open evening; the event was very well attended and found to be very informative.
The Reference Groups have expressed the opinion that they have a better understanding of NHS
issues following presentations.
The LHB and NHS Trust have always worked in a positive manner when engaging the PRGs
under the Public and Patient Involvement initiative.
The CHC continues to work proactively with Communities 1st Partnership Group to engage with
vulnerable and marginalized groups and to establish groups in these areas.
Work is ongoing to access groups such as non English speaking residents, the homeless and
travellers.
The CHC also is involved with the Youth Partnership Board and receives minutes and has had
input into the Single Children’s Plan for the Cardiff area.
The CHC will continue to develop its networks and aims to increase membership of the PRGs
during 2009 – 2010. This year is very important - as the NHS undergoes a major restructure it is
imperative that the citizens’ voice remains at the centre of Health Service planning and delivery.
35
CARDIFF AND VALE OF GLAMORGAN COMMUNITY HEALTH
COUNCILS COMPLAINTS ADVOCACY REPORT 1ST APRIL 2008 – 31
ST
MARCH 2009
The CHC Advocacy Service is now entering its 7th year as a full service across the whole of
Wales - although Cardiff and Vale residents have benefited from a year longer as this area was
involved in the initial pathfinder project.
Our service continues to be provided by two part-time Advocates working a total of 46 hours and
an Advocacy Support Officer working 25 hours. The Advocacy Service covers a population of
468,000 across Cardiff and the Vale of Glamorgan. We comply with national Advocacy
standards, confidentiality guidelines, and lone-working policies. Our aims are:
• To enable patients, carers and relatives to access information about their concerns and to
offer advice on the options available
• To support patients to put forward their concerns and complaints to the organisation for
investigation
The Advocacy role involves:
• Giving advice
• Doing necessary research
• Writing letters
• Providing support at meetings
Recording of Enquiries & Complaints Data
The complaints and enquiries which are received by CHCs across Wales continue to be recorded
on a specialist database system called Customisable Analysis Management System (CAMS) by
individual CHCs. This system enables information to be recorded and monitored throughout the
entire complaint. The data collected allows anonymised reports on complaints and enquiries to
be shared with CHC members prior to our council meetings. The Cardiff and the Vale of
Glamorgan CHCs send copies to Cardiff LHB and the Vale of Glamorgan LHB. These monthly
reports are then used to collate information for our annual report. Similarly, information from all
CHCs across Wales is collated into an annual report by the Welsh Board of CHCs which is sent
to the Welsh Assembly Government.
Enquiries 2008-2009
This year we dealt with 396 enquires, compared to 351 last year.
Enquiries are routine in nature. For example, where a member of the public requests information
on some aspect of health service provision, with no grievance against any treatment received
thus far. Our database allows the recording of details regarding these enquiries and data
collected can prove extremely useful e.g. during consultation periods regarding proposed
changes to service provision. No trends were detected during this period.
36
Enquiries
363
416
351
396
300
320
340
360
380
400
420
440
Number of enquiries
April 2005 - March 2006
April 2006 - March 2007
April 2007 - March 2008
April 2008 - March 2009
The nature of the enquiry is recorded in the CAMS database and the following table shows a
breakdown of the type of enquiries we have received this year.
Type of Enquiry Percentage of total (396 enquiries)
NHS complaint information 29%
NHS other 25%
NHS contact numbers 8%
GP other 6%
GP Complaint information 6%
Dentist other 4%
Non health related 4%
Waiting times 4%
Continuing care information 3%
Registering with GP 3%
All Other Enquiries 3%
GP Appointment 2%
Mental Health - Adult 2%
Discharge plan 1%
Complaints 2008-2009
The number of complaints we dealt with fell from 210 last year to 164, which may suggest that
we have supported fewer individuals. However, we have noted that the telephone and e-mail
contacts requesting general advice on the NHS Complaints Procedure has increased significantly.
When caller requests information on the procedure we outline the advocacy role and offer a
template that can assist them in drafting their own letter of complaint, should they wish to do so.
This information always includes an offer of a review by an Advocate if necessary. The number
of templates given between 2008 and 2009 was 30, compared to only 18 the previous year, a rise
of almost 50%. These figures illustrate the verbal advice being offered is being utilised by the
public with no further advice being sought. We continue to support patients and relatives with
37
complaints regarding all aspects of their healthcare. Examples of the complaints dealt with
include both clinical and administrative issues. These are often related to communication
breakdown, missed diagnoses, lack of appropriate care, staff attitude. We also support patients
who have already submitted a complaint and are experiencing difficulties in receiving a written
response in line with NHS guidelines. In this case we would offer support and advice on
submitting a complaint about the handling of the complaint.
Definitions of types of complaints
• Written – a formal letter of complaint sent to the relevant NHS organisation, requiring an
investigation and a formal written response under the NHS Complaints Guidelines.
• Oral – a potential written complaint which may be resolved by corresponding verbally
with the relevant organisation and which may not require a written formal response.
• Pending – a potential written or oral complaint which captures all the work carried out by
CHCs before the complaint is resolved orally or responded to in writing. This is an important
inclusion to the way that CHCs define complaints as very often a significant amount of work is
undertaken which for a number of reasons, does not then carry on to a written complaint. This
captures these details appropriately.
Complaints
0
50
100
150
200
250
Cardiff Vale Other Total
Area
Number of Complaints
April 2005 - March 2006
April 2006 - March 2007
April 2007 - March 2008
April 2008 - March 2009
The level of support provided is individual to each person and can vary depending on
progression through the NHS Complaints Procedure including Local Resolution, Independent
Review and Ombudsman applications.
• Local Resolution – this is the first stage of the Complaints Process and involves writing to
the health organisation responsible for the care/treatment relating to the incident to try to resolve
the matter at an early stage.
• Independent Review/Ombudsman – these two options are available if a complainant
remains dissatisfied with the Local Resolution stage. Investigations of complaints by these two
organisations are not automatic and will only be carried out if it is felt that additional information
can be gleaned from further investigation of the issues. During the 2008-2009 period a total of 2
38
cases were referred to the Independent Review Secretariat and a total of 7 were referred to the
Ombudsman.
Complaint Outcomes
A total of 85 cases have been closed this year and the following table shows the official NHS
outcome for these cases. The table illustrates yet again, the number of significant cases where a
formal complaint is not made. This may be for a number of reasons; the matter was resolved
informally with the help and support of an Advocate, or following discussion with an Advocate
the potential complainant, reconsidered their opinion.
In a small number of cases the complainant may change their mind and decide not to go ahead
with the complaint after the letter has been drafted. We record these types of complaints as
pending due to the amount of work and time involved even if they do not progress to a formal
complaint.
Outcome of closed case Percentage of total (85 cases)
Local Resolution 64%
Complaint not made 24%
No further contact 9%
Ombudsman 1%
Informal Resolution 1%
Other 1%
Most complainants (over 50%) tell us at the outset of their complaint that they are seeking an
explanation and / or apology. Others may be seeking treatment (16%), changes in procedures
(11%) or compensation (5%).
This correlates well with the actual case outcomes with 44% of complainants receiving an
apology and/or explanation, 3% received the treatment they were seeking and 5% of the closed
cases in this period resulted in process improvements of some kind. Some clients (2%) indicated
that they wished to pursue legal action but this figure may be inaccurate as we are not often
aware of the outcomes of cases that go to litigation.
Federation Working / Trend Analysis
The Advocacy team are based in the Cardiff office but are in regular contact with the Chief
Officer of the Vale CHC. Trend analysis and case reviews are regularly undertaken with both
Chief Officers and with presentations to all members. Any concerns relating to identified trends
in complaints are fed-back to the Chief Officer/s immediately and appropriate actions taken. The
Advocates routinely prepare briefing papers for monitoring visits at the close of the complaint.
They also liaise with Chief Officers regarding the need for un-announced visits, should this be
thought necessary.
39
Training
The Advocates continue to contribute to the national training programmes and have attended
several networking events to share experiences with colleagues throughout Wales. In addition,
this year the advocates and their support officer attended training sessions on the NHS Redress
Scheme, Patient Confidentiality and Disclosure and Child Protection awareness.
Liaison with CHC members
Please refer to Federation working / Trend Analysis.
Learning from complaints
The Advocates continue to encourage learning from complaints and contribute their experiences
in Trust Clinical Governance meetings and Complaints working Groups within Primary Care and
the Welsh Ambulance Trust.
Promotion
We continue to raise awareness of the Advocacy service. Examples are, newspaper articles,
radio broadcasts, display stands in supermarkets, visits to GP surgeries. The service has good
links with Barry College and each year give talks to students of the Association of Medical
Secretaries, Practice Managers, Administrators and Receptionists (AMSPAR).
Our website includes detailed information on the Advocacy service and the NHS Complaints
procedure and many complainants have contacted us after accessing this information or by
learning of our service from an Internet search. We continue to find that users of the service
welcome the personal service we provide and the majority of clients prefer us to draft letters on
their behalf.
Referrals
We regularly receive referrals from local solicitors, voluntary organisations and health
professionals. We feel this is recognition of the quality of service we provide and also the
promotion work undertaken.
Feedback on the Advocacy Service
We use the SNAP software package to record user feedback and a detailed analysis is available
at the close of this report. Feedback received from patients is that the vast majority are very
happy with the support and advice provided by the Advocacy service, even if they are not
completely satisfied with the outcome of their complaint.
Finally, Cathy, Samantha and Wendy would like to thank all CHC members for their continuing
support of the Advocacy service.
40
0
20
40
60
80
4300
17
70
1
No reply
Hospital
General Practitioner
Pharmacist
Optician
Dentist
GP Out of Hours Service
0
10
20
30
40
50
60
3
810
20
51
2
No reply
Excellent
Very Good
Good
Poor
Very Poor
o Which part of the NHS was your complaint regarding?
o How do you feel you were supported by the Advocate?
41
0
5
10
15
20
25
30
1717
27
15
18
No reply
Strongly Agree
Agree
Disagree
Strongly Disagree
0
10
20
30
40
15
2122
4
32
No reply
Strongly Agree
Agree
Disagree
Strongly Disagree
o Regarding your complaint - The Outcome was what I wanted?
o Regarding your complaint - The NHS answered all my questions?
42
0
5
10
15
20
25
30
1517
26
8
28
No reply
Strongly Agree
Agree
Disagree
Strongly Disagree
0
10
20
30
40
28
24
10
0
32
No reply
Strongly Agree
Agree
Disagree
Strongly Disagree
o Regarding your complaint – My complaint was taken seriously by the NHS?
o Regarding your complaint – I now have confidence in the NHS?
43
FUTURE PLANS FOR 2009 - 2010
Public Consultations
• To monitor the implementation of the Welsh Assembly Government consultation proposals
to re-structure the NHS in Wales – ie transitional arrangements, Cardiff and Vale
University LHB
• To continue to monitor the implementation of the consultation on Child and Adolescent
Mental Health Services for South Wales
• To respond to the consultation proposals on the Future of CHCs in Wales and to respond to
the Minister’s decision on that consultation
• To participate in the pre consultation process on Designed for Life – Programme for Health
Service Improvement
• To respond to consultation documents from NHS Wales and the Welsh Assembly
Government, when required
Monitoring NHS Services
• To carry out planned activity of monitoring NHS services in Cardiff secondary and primary
care.
• To develop a robust visiting model in relation to Nursing Homes, in co-operation with
identified Regulatory Bodies.
• To continue to develop a CHC Cancer Services Team to effectively monitor cancer
services across Cardiff & Vale NHS Trust and the Velindre NHS Trust.
• To respond efficiently to requests for unannounced visits when required
• To monitor the Cardiff LHB and Cardiff & Vale NHS Trust surrounding the
commissioning and provision of services in relation to the financial situation / pressures.
• To develop a robust system for monitoring Prison Health Care services.
• To monitor Mental Health Implementation.
• To continue to monitor Phase 2 of the Women’s Services Implementation
• To monitor the effectiveness of the Cardiff & Vale NHS Trust, Velindre NHS Trust and
Cardiff LHB Public and Patient Involvement Strategies.
CHC Public & Patient Involvement
• To maintain the CHC database of local organisations and groups to ensure views are sought
on local NHS Services
• To continue to support the Public Reference Groups across the city as long as funding has
been identified
• To further develop links with other organisations across the city
Cardiff CHC and Vale of Glamorgan CHC Advocacy Service
• To promote the work of the CHC and independent advocacy service to the residents of
Cardiff and the Vale of Glamorgan
Further details can be obtained from the Work Plan 2009-2010.
44
COUNCIL MEMBERSHIP 1ST APRIL 2008 – 31
ST MARCH 2009
Chair (2008-2009) Dr G Briwnant-Jones
Vice Chairs (2008-2009)
Miss M Davies
Mr RG Osborn
Welsh Assembly Appointments
Mrs DJ Court
Miss M Davies
Mrs MJ Driscoll
Mrs B Hampson
Mrs JD Lewis
Mr WT Mosley
Mr RG Osborn
Dr KT Rajan
Mr P Spight
Mrs F Webster
Mrs E Williams (Resigned)
Mr R Woodward
Cardiff County Council
Cllr K Davies
Mrs A Evans
Prof J Greve (Resigned)
Cllr M Islam
Mr F Lane
Cllr D Rees
Voluntary Organisation Appointment
Dr G Briwnant-Jones Welsh Food Alliance
Dr EN Cole MENFA – Mentoring for All
Mrs SJ Hutton Carers Centre
Dr C Kerby Penarth Youth Project
Mrs V Patel Sanatan Dharma Mandal and Hindu
Community Centre Cardiff
Co-opted Members
Mrs N Nicholas
Mr S Sims
Miss A Yusuf (Resigned)
45
MEMBERS ATTENDANCE AT COUNCIL MEETINGS 2008 – 2009
Title Initial Last Name
Meetings
Attended
Maximum
Attendance*
Dr G Briwnant-Jones 12 12
Dr EN Cole 11 12
Mrs DJ Court 7 12
Cllr K Davies 2 7
Miss M Davies 11 12
Mrs MJ Driscoll 11 12
Mrs A Evans 3 12
Professor J Greve 1 4
Mrs B Hampson 7 12
Mrs SJ Hutton 9 12
Cllr M Islam 2 7
Dr C Kerby 11 12
Mr F Lane 10 12
Mrs JD Lewis 9 12
Mr WT Mosley 8 12
Mrs N Nicholas 8 11
Mr R Osborn 11 12
Mrs V Patel 6 12
Dr K Rajan 12 12
Cllr D Rees 4 13
Mr S Sims 10 11
Mr P Spight 8 12
Mrs F Webster 8 12
Mrs EM Williams 4 8
46
Mr R Woodward 11 12
Miss A Yusuf 1 5
* The maximum attendance at Cardiff CHC council meetings is 12, including the
Annual General Meeting. This list does not include the Cardiff CHC Business, Training
and Development Meetings, CHC Primary Care Group Meetings or any other CHC
meetings.
47
EXAMPLES OF ATTENDANCE AT CONFERENCES / SEMINARS
/ LECTURES
• Welsh Assembly Government: Treatment of Cancers with Orphan Medicines -
Ensuring Patients Benefit held on Wednesday 16th April 2008, The Assembly
Officer, National Assembly for Wales - Dr G Briwnant-Jones
• Primary Care Mental Health and Education and Wales Mental Health in Primary
Care: 'Creating Mental Wealth' Conference held on Tuesday 29th April 2008, City
Hall, Cardiff - Mr R Woodward
• Asthma UK Cymru ‘World Asthma Day’ held on Tuesday 6th May 2008, Neuadd,
Senedd Building, Cardiff Bay – Dr KT Rajan
• Cardiff & Vale NHS Trust Nursing and Midwifery Celebration Week Women and
Children's Service Group held on Thursday 15th May 2008, Sports and Social
Club, University Hospital of Wales - Dr C Kerby and Mrs N Nicholas
• Primary Care Cardiovascular Society and South East Wales Cardiac Network:
Inaugural Meeting - Controversies in Cardiovascular Care held on Wednesday
21st May 2008, Park Plaza Hotel, Greyfriars Road, Cardiff - Dr KT Rajan
• Welsh Assembly Government 'Preventing and Fighting Infection During
Treatment for Cancer' held on Tuesday 17th June 2008, Conference Room 21,
Welsh Assembly - Dr G Briwnant-Jones
• Wales Cancer Bank and Cancer Research Wales Update: An Information Event
for Patients and Carers held on Tuesday 8th July 2008, Premier Suite, Glamorgan
Cricket Club, Sophia Gardens, Cardiff - Mrs JD Lewis and Mrs N Nicholas
• Alzheimer's Society: Younger People with Dementia Information Day held on
Thursday 10th July 2008, Function Room, Harry Ramsdens, Cardiff Bay - Mrs F
Webster
• Welsh Board of CHCs Winter Conference: The Future of CHCs in Wales held on
Friday 19th September 2008, Newtown - Dr G Briwnant-Jones, Mrs MJ
Driscoll, Mr RG Osborn, Dr KT Rajan; Mr S Allen and Mr M Jenkins
• Nursing and Midwifery Council Stakeholder Event held on Monday 29th
September 2008, Cardiff - Mrs MJ Driscoll
• Velindre NHS Trust: Velindre Cancer Centre - Lymphoedema Patient Awareness
Day held on Tuesday 4th November 2008, The Welsh Institute for Sport, Sophia
Gardens, Cathedral Road, Cardiff, CF11 9XR - Mrs N Nicholas
• Velindre NHS Trust 3rd Annual Research and Development Conference 2008
held on Thursday 6th November 2008, Village Hotel and Leisure Club, Cortyton,
Cardiff – Mrs JD Lewis, Mr WT Mosley and Mrs N Nicholas
48
• Cardiff & Vale NHS Trust Official Opening of the Iorwerth Jones Centre by The
Rt Hon Rhodri Morgan AM (First Minister for Wales) held on Friday 21st
November 2008, Main Lounge, Iorwerth Jones Centre, Trenchard Drive,
Llanishen, Cardiff CF14 5LJ - Dr G Briwnant-Jones and Mr M Jenkins
• Teenage Cancer Trust and Cardiff & Vale NHS Trust: Teenage Cancer Trust Unit
Open Day held on Friday 23rd January 2009, Teenage Cancer Trust Unit,
University Hospital of Wales, Heath Park, Cardiff, CF14 4XW – Dr C Kerby,
Mrs JD Lewis, Mr WT Mosley and Dr KT Rajan
• Alzheimer’s Society: Event to Celebrate the work of the Alzheimer’s Society held
on Thursday 26th March 2009, St Fagans National History Museum – Mr R
Woodward
• Cardiff & The Vale Mental Health Development Project: ‘The Hidden Service’
Carers speak about their experience of caring for older people with dementia held
on Tuesday 31st March 2009, All Nations Centre – Dr EN Cole