Meeting documents

Apologies for absence were received from Kerry Stevens, Christine Nicolay, Ryan Mellett, Michael Colston, Frances Finucane, Emma Parry and Marilyn Park.

Councillor Pam Bacon declared a personal interest in that she sat on the Adult Social Care Policy Advisory Group.

To agree the Minutes of the meeting of the Older People’s Champion’s Group on 2 May 2007 as a correct record

The Minutes of the meeting on 2 May 2007 were confirmed as a correct record.

Item 3, para 1 It was requested that the clerk circulate the Terms of Reference of the Adult Commissioners to the Champion’s Forum with the agenda for the next meeting.

Action: Sheilah Moore

Item 3, para 2 Anne Banks indicated that the Hospitals Trust had introduced a policy regarding bed movement. Patients were to be moved no more than 3 times, from the Medical Assessment Unit, to a specialist ward and then a rehabilitation ward. There was not thought to be a role for the Champion’s Forum at this time in monitoring beds moves. The Chairman commented that it was the Champions who had drawn attention to the issue and welcomed the introduction of the policy on bed moves.

Item 3, para 3 Anne Banks reported that currently, there was no ward at Stoke Mandeville for older people with non-specific medical conditions. However, Hospital beds within the Trust were being reconfigured. Anne Banks would report back at the next meeting of the Forum.

Action: Anne Banks

Item 3, para 4 The Chairman mentioned that she had still not received a recording of the meeting that she and Kerry Stevens had attended with the Hospitals Trust on 4^th December 2006 regarding the pathway analysis of care provided to a 94 year old lady. Anne Banks had requested that the recording be sent and agreed to follow up on this.

Action: Anne Banks

Item 3, para 5 Anne Banks reported that an open day for potential Older People’s Champions was being planned for the following year. The Chairman requested that the Older People’s Champion’s Forum be involved in this event.

Item 3, para 6 Anne Banks reported that the Hospital Trust had held 3 "in your shoes" days  in Aylesbury, Amersham and Wycombe respectively where staff had been matched with previous patients as a way of sharing patient experiences. The events had proved very successful and information gleaned was being compiled into a report. The Champions requested a copy of the report when available.

Action: Anne Banks

Sheila Davies, Health Promotion Co-ordinator

Sheila Davies reported that the theme of the 5^th Bucks Older People’s Forum Conference Speaking out – Making changes was engagement with older people and how to involve them in the decisions that affect them.  100 delegates from all across the County met in Chesham at the Chartridge Conference Centre. A specific request from the Forum had been that no professionals be invited unless speaking or supporting the conference, as in previous years it was felt that they dominated discussions.

The key note speaker was Matt Briggs from Department of Work and Pensions leading on the government’s new Transformational Government team looking at how services for older people could be developed and reorganised. The theme of user engagement / involvement continued throughout the 5 workshops.

Some of the threads emerging through the workshops:

General issues:-

• Poor transport especially in the evenings, as well as its frequency
• Routes not taking older people where they need to go eg GP surgeries, adult education centres
• Library closures
• Need to get information into the heart of communities
• Individualised  responses, not getting a standardised answer
• Being treated with respect
• Bus passes only being eligible in home county
• Consistent communication between professionals

Problems identified in the way people had been consulted / involved in the past:-

• People feel that consultation is already decided before it is done, there is too much consultation and no action afterwards
• People don’t feel they have receive information directly
• People don’t feel consulted on key issues such as transport

How would you improve community involvement and participation:-

• "Need real people talking to us in a real way"
• Use existing channels of communication eg radio, supermarkets
• Work on issues in the communities where they live and make it feel more personal
• Introduce a buddy system for services users to give confidence
• Offer prizes for consultation involvement

A full report would be presented to the Buckinghamshire Older People’s Forum AGM in October.

A member enquired about the possibility of reduced train fares for Older People.

The Chairman thanked the Bucks Older People’s Forum and everyone involved for their hard work in setting up the event. A member of the Champion’s Forum suggested that in future years, taxis collect more than one passenger form a locality to save money.

Graham Box, Management Consultant

Graham Box reported that, in a project funded by Buckinghamshire County Council, four pairs of interviewers (all but one of them are lay people aged fifty and over) had been trained to carry out discovery-type interviews with older people who have been inpatients at the Acute Trust or who attend the Day Hospital. This was a pilot study and ten patients have been interviewed.  Their stories had been transcribed and shared with the Acute Trust (though there were messages for other organisations as well).  The interviews had covered the admission process, being in the hospital, being discharged, settling back home and (for those who attended) their experience of the day hospital.

Some patients expressed highly favourable views on the care that they had received. However, several issues had been raised around:

• Person centred care
• Delays and duplication
• Food and sleep
• Discharge and follow up
• Personal hygiene

Whilst many of the problems raised might not be new to providers and commissioners, it was hoped that the authenticity of the approach, hearing the genuine voices of local patients, would give added impetus to making improvements in the areas highlighted. Anne Banks agreed that they interviews had been very valuable and she undertook to provide a written response to the Forum.

Action: Anne Banks

Graham Box recommended that the Champion’s Forum support the completion of roughly six more interviews with older people identified as users of social care. A member suggested that these take the form of follow-up interviews with those already interviewed who had gone on to use social care services. There was broad support for this approach and Graham Box indicated he would discuss this further with Kerry Stevens and report back to the next meeting of the forum.

Action: Graham Box

Pam Bacon suggested that the discovery interview report could be passed to the Public Health Services Overview and Scrutiny Committee as a way of formalising the work and its recommendations. Graham Box and the Committee’s Policy Officer, Angela Macpherson, could discuss this further outside of the meeting.

Action: Graham Box

Anne Banks / Marilyn Park, Buckinghamshire Hospitals Trust

This item was covered under Matters Arising from the Minutes.

Pam Bacon, County Councillor and Overview and Scrutiny Committee member

Pam Bacon reported that she had attended one of the "In your shoes" meetings run by the Hospital Trust and had shared her experiences of inpatient care at Wycombe Hospital the previous December. Issues she had raised at this meeting revolved principally around nursing care. Mrs Bacon understood that action had already been taken to address issues of concern.

Anne Banks explained that staff on assessment wards were now returning to wearing uniforms; staff were required to wear an identification badge on the wards; the nursing structure had been reorganised and a new matron appointed; it was considered a disciplinary matter of staff did not talk in English to patients on the wards and the medical assessment unit had been painted and the physical environment improved.

Anne Banks added that the "In your shoes" meetings had been a great success and it was anticipated that more such meetings would be held the following year.

No comment was made.

There was some discussion around the future of the Champion’s Forum in Buckinghamshire. Broad support was expressed for continuing with the Champions Forum which had played an important role in bringing issues to the fore, both through the case study and the peer interviews. Members felt it should only continue if the problems identified below were addressed.

1.   Lack of status and authority:  The champions were not consulted on and kept informed about important issues and changes that affect older people.  They struggled to hold the OPPB to account and did not have a slot on that agenda to raise their concerns at every meeting.  The acting lay chair did not receive the information that was routinely shared among professionals and was therefore not well placed to intervene on behalf of older people.

2.   Lack of focus and impact: The champions used to contribute to the NSF for Older People Standards working groups.  Their demise had diluted the focus of the group and made the champions influence within the system far less tangible.

3.   Lack of commitment from the statutory sector: At the September meeting, which was intended to see a reinvigoration of the Champions, there was no representation at senior manager level from the Primary Care Trust, the Mental Health Trust, the Ambulance Trust or Social Care.

4.   Lack of senior management ownership: There was no senior manager with responsibility for the champions and, as a result, the network had dwindled over the preceding 18 months, rather than being built up.

5.   Lack of clarity: The lay people present did not understand if they were there to represent groups such as their Older People’s Action Group or whether they speak for themselves.  Nor were they clear on how decisions were made, who made them and how they could be influenced.

It was agreed that the following recommendations would be made to the Older Peoples Partnership Board:

a.         The Champions Forum needs to be chaired by someone who is linked to the whole system network of health (primary and acute) social care and community services.(a professional manager at a high level, or clinician).  This person should be identified by the OPPB in partnership with the Champions Forum Chair and acting Chair.  There should be a lay co-chair.

b.         A senior manager should be given responsibility for the champions network.  Their role would be to grow the number of champions for older people across Buckinghamshire to become a vibrant body.  The membership of the Champions Forum would be drawn from that wider network.

c.         All of the relevant statutory organisations should commit to the Champions Forum and send substitutes when their nominated representatives are unable to attend.  They need to keep the Champions Forum informed about changes and issues that relate to older people.

d.         Mechanisms need to be established that allow the Champions Forum to influence the agenda of the OPPB and to allow the Champions Forum a regular, dedicated slot at OPPB meetings.  The Champions Forum  ...  view the full minutes text for item 9.

None was raised.

30 October at 2.30 pm in Mezzanine Room 1

30 October at 10.00am in Phoenix Room 3.