Cardiff Community Health Council Annual Report 2008 – 2009€¦ · 5 CHAIR’S REPORT - DR GWYNETH BRIWNANT-JONES Staff and members of Cardiff Community Health Council (CHC) have

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


Primary Care / Patient & Public

Involvement Officer

Mr Stephen Allen 029 20 377409


Patient Advocates Mrs Cathy Moss 029 20 377432

Email [email protected]

Mrs Samantha Perrett 029 20 377431


Advocacy Support Officer Mrs Wendy Orrey 029 20 377413


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


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


Wales

27th August 2008

Haematology / Bone Marrow Unit


Wales

12th September 2008 Ward C 1 – Maternity Services


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


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


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


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


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


Program for Health Service

Improvement (PHSI) Project

Pre-Consultation Update

6th May 2008


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


North Groups

Presentation – Clinical Director,

Unscheduled Care Directorate &

Consultant in Emergency Medicine

22nd September 2008


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




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





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

Documents

Cardiff Community Health Council Annual Report 2008 – 2009€¦ · 5 CHAIR’S REPORT - DR GWYNETH BRIWNANT-JONES Staff and members of Cardiff Community Health Council (CHC) have