Trust Board papers November 2012 - Barking Havering and ...

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The Co-Chair of the Improving Patient Experience Group (IPEG) Mrs Elaine Clarke raised the point that
there was no provision for End of Life Care for patients with long term conditions, as with these patients it
was difficult to assess when they would die. The Quality & Safety Committee would also consider this
cohort of patients and provide the Board with their recommendations.
The Board noted the key achievements during 2011/12 and the work now in progress.
The Trust Board agreed that the Quality & Safety Committee should discuss and agree the named
Executive Trust Lead for End of Life Care and this individual would chair the End of Life Care Advisory
Board (previously chaired by the Director of Nursing).
Action: Caroline Wright/Anthony Warrens 7.11.12
2012/056 DEMENTIA STRATEGY – PHASE 2
Ms Douglas presented the Dementia Strategy – Phase 2, which included meeting the National CQUIN and
the roll out of the Butterfly Scheme. All the work in the Dementia Strategy would be undertaken in
conjunction with the Elderly Care Strategy.
The Dementia Strategy was launched in 2010 and following a gap analysis against the National Dementia
Strategy, 17 key objectives were agreed. Ms Douglas informed the Board that a Dementia Steering Group
had been established and an Action Plan agreed. She also confirmed that the Trust’s overall
responsibilities would be monitored through the Action Plan, in order to ensure a smooth pathway from the
community into hospital. BHRUT had worked with North East London Foundation Trust (NELFT), as they
were the leading partner for this Strategy. This Strategy was part of the operational plan requirements
from the Department of Health to improve Dementia Services for all. The Board agreed it would be useful
to see the framework of the organisations involved, in order to understand the structure.
It was noted by the Board that the Borough of Havering had the highest population numbers in this
category and this was going to increase by at least 15% over the next ten to fifteen years. The Trust
therefore needed to prepare for this and be assured that someone would be taking this on, as the Board
did not currently have confidence that the organisation was in a position to meet the challenges that would
present themselves over the coming years. The Chief Executive advised the Board that she would be
attending an Integrated Care Coalition meeting with members of the Cluster tomorrow and she would
ensure that the Board’s concerns were raised there.
Dr Dalziel referred to the earlier End of Life presentation and the requirement for both of these to be linked
in a different cultural approach towards people dying, whether they had dementia or not. A lot of patients
were at home, rather than in hospital, and it should be acknowledged that this was quite complicated and
needed to be brought together in some way.
The Interim Chairman raised the point relating to Discharge Coordination rated ‘red’ in the Action Plan and
the requirement for a Trust Lead to be agreed as part of the restructure. Ms Douglas confirmed to the
Board that there was a lot of work ongoing on the Wards regarding the discharge coordination of patients
with dementia, in order to ensure patients were being discharged appropriately. The identification of a
Trust Lead was obviously a priority, as the Action Plan stated the timescale as January 2012. Questions
were raised as to why this timescale had slipped and how this fitted into the whole Governance
Framework. The Board agreed that Ms Douglas would go back and review with the relevant clinicians if
there was a case to recruit someone for this post, or for Dr Mike Gill, the Medical Director, to be the Lead.
Mr Langley referred to a further ‘red’ rated theme on the Expected Outcome Measures in relation to
Improved patient and carer experience and the outcome noted as ‘data non specific for dementia’. He had
concerns that there was insufficient measurement criteria to provide comfort to the Board. Ms Douglas
agreed that there was some work to do on this linking to the patient pathway and the Butterfly Scheme and
she informed the Board that this would all be tied together.
The Board noted the impact of dementia and the staggering numbers involved with 700k people living with
dementia in England, with this number likely to double over the next thirty years, costing the UK economy
£17bn per year. With the expected increase in patients, the costs in the next thirty years would rise to
Trust Board Minutes Part I – 5 September 2012