Public Session

PATIENT SAFETY/QUALITY

ASSURANCE REPORT

NHS ROTHERHAM CCG

3rd

JUNE 2015

CONTENTS

1. HEALTHCARE ASSOCIATED INFECTION ............................................................... 3

2. MORTALITY RATES .................................................................................................. 3

3. SERIOUS INCIDENTS (SI) AND NEVER EVENTS (NE) ............................................ 4

4. CHILDREN'S SAFEGUARDING ................................................................................ 4

5. ADULT SAFEGUARDING .......................................................................................... 7

6. ADULT CONTINUING HEALTHCARE ....................................................................... 9

7. CHILDREN’S CONTINUING HEALTHCARE ............................................................. 10

8. PERSONAL HEALTH BUDGETS (PHB) ................................................................... 10

9. FRACTURED NECK OF FEMUR INDICATOR .......................................................... 11

10. STROKE ..................................................................................................................... 11

11. CQUIN UPDATE ........................................................................................................ 11

12. COMPLAINTS ............................................................................................................ 12

13. ELIMINATING MIXED SEX ACCOMMODATION ....................................................... 12

14. CQC INSPECTIONS ................................................................................................... 12

15. ASSURANCE REPORTS ........................................................................................... 13

16. CARE AND TREATMENT REVIEWS ......................................................................... 14

17. WINTERBOURNE SUBMISSION ............................................................................... 14

Appendix 1 – Childrens Continuing Care Service User Feedback .................................... 15

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NHS ROTHERHAM

1. HEALTHCARE ASSOCIATED INFECTION

RDaSH: There have been no cases of healthcare associated infections so far for the current year.

Hospice: As at the end of Quarter 4, there was 1 patient admitted to the Hospice who already had MRSA and 1 patient who already had C-Diff. No information is available yet for 2015/16.

TRFT :

MRSA – 0

MSSA – 5 (monthly actual) 5 (YTD)

E Coli – 14 (monthly actual) 14 (YTD)

C-Difficile:

TRFT

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

2014/15 Trajectory

= 24, actual 31

Monthly Actual

0

Monthly Plan

2

YTD Actual 0

YTD Plan 2 4 6 8 11 13 15 17 20 22 24 26

NHSR C-Difficile

NHSR

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

2014/15 Trajectory

= 66, actual 82

Monthly Actual

4

YTD actual 4

YTD Plan 5 11 17 23 27 31 36 42 47 53 57 63

The above tables represent the cases to date which have been signed off (14th of each Month) on the MESS database. Please note the above figures may not exactly match the C.Diff figures which are discussed at the Post Infection Review meetings with TRFT.

Post Infection Review – Overview Panel (C.Diff cases)

Next meeting to be held on the 26th May 2015.

2. MORTALITY RATES

The latest data (as at December 2014) submitted from TRFT in Dr Foster shows the HSMR performance measure to be at 99.80 year-to-date which is within the ‘Expected’ range. It is noted that there is an upward trend from previous year but less than 2012/13, this is being carefully monitored.

The SHMI performance now stands at 105.32 which is also within 'Expected' banding. This shows a minimal reduction on previous year.

Following a review of the top ten diagnosis groups from Dr Foster audits have begun to determine whether there are any underlying concerns around care. These include acute and unspecified renal failure, liver disease alcohol related, senility and mental disorders. This is overseen by the Associate Medical Director with a view to developing an action plan depending on the findings.

The majority of deaths are in Health Care for Older People (HCOP) and General Medicine as expected, reviews are taking place in these areas and the figures are still to be validated. The December 2014 figures were significantly higher than in other months. A thorough review of those is being undertaken by the Associate Medical Director.

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3. SERIOUS INCIDENTS (SI) AND NEVER EVENTS (NE)

SI Position 21.04.2015 – 18.05.2015

TRFT RDASH NHSR CCG

Ind. Contractors

Roth residents out of area

YAS PHE/ NHSE

Open at start of period 46 15 1 0 2 1 0

Closed during period 10 6 0 0 1 1 0

De-logged during period 1 0 0 0 0 0 0

New during period 5 2 0 0 1 0 0

Open at end of period 40 11 1 0 2 0 0

Including New Never Events 1 0 0 0 0 0 0

Including Closed Never Events 1 0 0 0 0 0 0

New Trends and themes 0 0 0 0 0 0 0

4. CHILDREN'S SAFEGUARDING

Date Discussion Outcome Follow up

April 2013 to present.

Following two suicides (Nov 2012, Feb 2013) children and young people at a local school also had to contend with the tragic expected death of a young person (April 2013).

RLSCB have published multi agency practice guidance on handling potential suicide clusters. This document has been shared with other areas as the incidence of adolescents suicide is increasing. The document has been discussed with the national NHS England Safeguarding Lead as good practice guidance.

The rate of suicides in Rotherham is recorded as 8.9 with the national rate for England of 8.8 per 100,000

An Independent Author was commissioned to publish a lessons learnt document.

The DCS has reviewed the report and is making plans to publish. An Extraordinary HWBB was held on May 18

th

RCCG Comms Lead involved in managing the press.

February 2015

The All-Party Parliamentary Group (APPG) on Suicide and Self-Harm Prevention was published.

Rotherham is credited as hosting a suicide prevention conference in 2013 and producing a resource for workers and the public called ‘CARE’ which encourages them to act on Concerns, Ask about Suicide, Respond and Explain their actions to help a person at risk.

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Date Discussion Outcome Follow up

Aug2014/Jan 2015

Child Sexual Exploitation (CSE) Report published Aug 2014.

Report published August 2014, media interest immense. Negative press received for LA and Police.

National training on CSE commissioned for senior health professionals – September 2014.

Front line staff undertaking ‘Stop the Shift awareness raising’ 62% of CCG staff responded to the follow up questionnaire. The level of awareness raising was significant.

A bi-monthly ‘health’ focus group has been set up to co-ordinate a health economy response to national recommendations and the Alexis Jaye Health recommendation. This group has completed the work and will present a paper to LSCB Quality Sub Group.

Second tier of CSE training for front line staff commissioned to consider victimolgy took place in February just under 800 participants attended and the CSE pocket guide was launched. Next step RCCG to co-support financially training within all comprehensive schools as a preventative measure. Education will lead on this work and it has been financed for 2/3 years.

January 2015 Attendance by RCCG at CSE Gold and Silver Group has established a process for capturing local CSE issues.

Deputy Designated Nurse attending from April 2015 and works closely with the Named GP to ensure information is appropriately shared with primary care.

RCCG has set up a data base to map information on high risk CSE children

Named GP highlights high risk cases to individual GP Practices for them to flag concerns

Named GP/RCCG alert GP Practices and/or other health related organisations of areas of concern.

The data base is accessible to the RCCG Executive Lead for Safeguarding if further information is required. Future plan will be to monitor any themes and trends.

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4.1 Drivers for Change:

Date Discussion Outcome Follow up

23 – 27 Feb 2015

CQC Inspection of Children Looked After and Safeguarding (CLAS) undertaken.

The final day feedback provided lots of positives and several challenges. Each provider has written an immediate action plan to support taking forward the initial feedback.

LAC require a written summary of their health care.

Several issues raised with regard to CAMHS. A number of workstreams have been taken forward.

Maternity in-patients required work with LA social care. Initial meetings held and appear to be working through challenges.

CCG have subsequently provided a non-recurrent funding to purchase appropriate tools to enable health care to be summarised.

23 – 16 Feb 2015

TRFT had there CQC Essential Standards inspection which included Outcome 7 (safeguarding)

Feedback restricted to verbal. Written report due.

June 2014 Independent Review of NHS and Dept of Health into matters relating to Jimmy Savile. Monitor letter for a response by Foundation Trust 15.6.15

Rotherham health providers are undertaking a review of the recommendations and will report their findings to the CCG as well as Monitor.

Awaiting responses, both providers will share these with CCG

October 2014 Ofsted Inspection of Local Authority completed. Rotherham received an Inadequate Grade.

Feedback –the government have appointed a number of independent commissioners to oversee improvements and new DCS appointed.

LA has set up an improvement panel to consider implications and drive up changes. RCCG Chief Officer and Chief Nurse attending.

Rotherham health economy is fully committed to safeguarding (one of four priorities in the Commissioning Plan)

Chief Nurse/Chief Officer sit on Improvement Board

Deputy Designated Nurse commenced post 12 January 2015 same day as an independent manager to drive forward agency input into the Multi Agency Safeguarding Hub (MASH) and therefore support on-going improvements in safeguarding children. MASH commenced 1 April 2015

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Date Discussion Outcome Follow up

March 2015 Rotherham CCG has commissioned 2 health secondees to work within the Rotherham Multi Agency Safeguarding Hub (MASH)

Commissioners of health services in Rotherham will work within the MASH to ensure that an evidence base is established to support future commissioning whilst supporting all agencies, including health providers, in developing an effective MASH.

An interim review presented to OE 16 March 2015.

A follow up report due in Sept/October 2015 to support and provide evidence for commissioning health care 2016/2017 with a final report to be published January 2016.

4.2 Learning Review

Area Discussion Outcome Output

May 2013 Croydon

TRFT and RDaSH have completed an Individual Managements Report (IMR) for an external LSCB, namely Croydon.

The methodology used is Significant Incident Learning Process (SILP).

Letter sent from RLSCB (31.12.2013) regarding closure of Rotherham actions to Croydon LSCB.

Rotherham LSCB is following up local recommendations to ensure compliance via the SCR Panel December 2013, completed actions sent to Croydon LSCB.

June 2014 Update from Croydon with regards to publication, it was agreed by Croydon LSCB that the Overview Report required further work.

The report was scrutinised (Jan 2014) and dependent on the outcome will be published after the Coroner’s Inquest.

The report was published by Croydon Safeguarding Children Board 21 April 2015.

6.3.2014 19.2.2014 SCR Panel met to discuss injuries sustained by a Rotherham infant. The injuries were potentially non-accidental and whilst under investigation the infant sustained further bruising.

SCR Panel has agreed the methodology and terms of reference of the SCR.

The methodology to be utilised is a Significant Incident Learning Process (SILP).

Media reporting following court case to restrict access by father - highlights child injured whilst in hospital.

SCR Panel meeting to discuss publication 16 April 2015

5. ADULT SAFEGUARDING

5.1 Headlines

Rotherham Safeguarding Adult Board (RSAB) met on the 20th May and was informed that Professor Pat Cantrill has again tendered her resignation, as Independent Chair and this has been accepted. Graeme Betts (Interim Director of Adult Social Services) chaired this meeting. The Chair raised concerns that a Serious Case Review had not been conducted within Rotherham for a number of years – he has therefor asked Sam Newton to review recent incidents over the last 3 years to provide assurance that these had been fully investigated.

The CSE Adult Survivors board has commenced. The RSAB have highlighted the need to develop a collaborative working approach to taking this work forward.

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The South Yorkshire and Humber Safeguarding Adults Partner Self Assessments that were completed by members of the Board were discussed and it was agreed that a lot of “good practice “ is taking place. This is the first time in Rotherham that these have been completed and it proposed that these are to be completed on an annual basis using the same template which is used across the region.

The Chair informed the Board that he has requested independent review of the Rotherham Safeguarding Adult Board in order to identify any gaps but to also highlight good practice. The independent reviewer will also want to speak with members of the board. Sam Newton is to arrange this. The chair informed the board that these findings will direct the board in terms of future work.

The next RSAB is to meet on the 1st July.

The RSAB sub group is to meet on the 2nd June.

Deprivation of Liberty (DoL) -The Safeguarding Lead and the Head of Quality are working with the Continuing Health Team in relation to identifying those clients with health commissioned care packages within the community who meet the “acid test” (under continuous supervision and control and are not free to leave and lack the capacity to consent). Further work is also been undertaken in relation to who is most appropriate to complete the relevant paperwork e.g a Best Interest Assessor or the Continuing Health Team in order to progress to the Court of Protection to ensure that RCCG is not unlawful depriving a individual of their liberty.

5.2 Care Home update

Care Home – The meeting that had been arranged to discuss the concerns of CQC has now been cancelled due CQC no longer pursuing a warning notice. The home is not in contract default but have an action plan in place which will be monitored by the Contract Compliance Team at RMBC.

Care Home – The voluntary suspension still remains in place however improvements have been noted by the Continuing Health Care team in relation to documentation and the general “feel/running” of the home. Two qualified staff have been employed reducing the need for agency staff. Work is still ongoing towards the correct use of the MUST tool and first line treatment and a number of training sessions have been arranged. The care home manager is working with the DoL’S team (Deprivation of Liberty Safeguards) at RMBC re applications. The Care Home support team also reported to the CQC meeting held at Riverside on the 13th April that improvement to the “quality” of care had been observed.

Care Home – The voluntary suspension has now been lifted following a CQC inspection.

5.3 Delayed Transfers of Care (DTOC)

The CCG continues to work with RMBC and RDaSH colleagues to finalise both the Adult & Older Peoples discharge pathways. It is anticipated that both pathways will be fully signed off at the next strategic meeting which will be scheduled in the next 4 weeks.

The RCCG is now putting in place a process through which the mental health case manager will review all current and potential discharges in partnership with colleagues from RMBC and RDaSH to improve accuracy of recording and work with the provider to develop action plans for each case.

Recent experience has indicated that the implementation of the ‘Who Pays’ guidance, relating to 117 placements, 2013 is likely to significantly increase delays for those individuals for whom we are seeking an out of area placement.

See following graphs of DTOC for Adult & Older Peoples services:

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6. ADULT CONTINUING HEALTHCARE

6.1 Headlines

The Continuing Healthcare team (CHC) have attending process mapping meeting with providers to support CHC process, education and advice.

A significant increase in referrals to CHC, has been identified on the discharge to assess pathway, this will hopefully improve the number of delayed discharges.

6.2 Reports

W/C 16 Mar 2015 13 Apr 2015 11 May 2015

Total Number Eligible Patients 648 638 642

Total % Outstanding Reviews 46.30% 49.22% 49.14%

Total Number of Outstanding Reviews 300 314 315

Number of LD Team patients Eligible 122 125 128

% of LD Team reviews outstanding 73.77% 68.80% 65.63%

Number of outstanding LD Team reviews 90 86 84

Number of CHC Team Patients Eligible 526 513 524

% of CHC Team outstanding reviews 39.92% 44.4% 41.1%

Number of CHC Team reviews outstanding 210 228 221

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The table identifies the total number of patients eligible for funding from Rotherham NHS Continuing Health Care, the lower two graphs are divided into the two responsible teams for conducting reviews which are the adults and learning disabilities teams, illustrating the breakdown of outstanding reviews in each area.

New processes such as the completion of 1st DSTs for community patients and changes in eligibility are increasing the amount of reviews that are require to be undertaken. this has had a huge impact and increase on the amount of 3 monthly assessments required.

7. CHILDREN’S CONTINUING HEALTHCARE

7.1 Headlines:

The Children’s Continuing Care (CCC) Team have developed a survey/questionnaire for our Service User’s. This is intended to be used in order to improve our service, where needed. CCC Questionnaire as attached at appendix 1.

Our team have also updated the Children’s Continuing Care Training Package and hope to arrange some further training dates for our colleagues in Health, Education and Local Authority Children’s Services.

7.2 Reports

Total number of DSTs undertaken: including reviews: 92

Months January

15 February 15 March 15 April 15 May 15

Total number of Eligible patients

22 + 1 fast track

24 + 1 fast track

27 + 1 fast

track

30 + 1 fast

track 34

Total outstanding

Reviews 1 (0.23%) 0 0 0 0

8. PERSONAL HEALTH BUDGETS (PHB)

8.1 Current Caseload

5 new referrals in total have been received by the PHB team in April, initial visits have been arranged for 3 of these referrals and 1 was referred to the local authority:

1 child

1 Joint Package of Care (JPOC) - referred to Local Authority (LA)

3 CHC

The current PHB caseload in Rotherham is 68:

20 Joint Funded PHB cases plus 1 new referral, who are in receipt of funding both from the Local Authority and Health. The Local Authority manages these 20 PHB cases =21

32 PHBs, 18 of these are in progress, 12 have been signed off by the Approved Person, 2 are on hold due to a family bereavement and end of life

15 children, 2 of these have been signed off by the Approved Person

8.2 PHB Feedback

One current care package is Personal Assistant (PA) support provide by AKA for 14 hours waking support and sleeping nights plus a 2hr double up provided by Kinetic. Kinetic gave 24hr notice that they would not be providing the 2hr call due to an allegation that DF had caused injury to a carer.

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AKA have been supporting this call in the short term whilst an alternative agency has been sourced.

8.3 Moving Forward

Rotherham CCG is aiming to support all individuals requesting a PHB. The following people have signed up to the moving forward programme to look at rolling out PHBs for Mental Health:

Kirsty Leahy ( safeguarding ) ( in place of Alun Windle, CCG lead)

Mandy Toone ( PHB advisor) in place of Amanda Johnson ( personalisation lead)

Alison Lancaster ( Mental Health Provider lead)

Jenny Greaves ( Local Authority)

Rebecca Bates ( Mental Health Services ) – unable to attend first meeting

A further meeting is to be organised for the beginning of June.

9. FRACTURED NECK OF FEMUR INDICATOR

The Q4 position showed a sustained decrease from rest of year. The Trust has worked hard to keep the numbers attending low with on-going work in the community and this has led to the full year target of 264 or less being achieved with the actual number attending hospital being 243.

10. STROKE

The year-end position shows an underachievement against four of the national Stroke targets, in particular the percentage of people who have had a stroke who are admitted to an acute stroke unit within 4 hours of arrival to hospital and the percentage of stroke patients scanned within 1 hour of hospital arrival.

There has been a significant increase in the percentage of patients spending at least 90% of their stay on a Stroke Unit from a position of 72.2% in January to a position of 83.33% at the end of Q4. This improvement has been supported by the newly developed Standard Operating Procedure for protecting 2 stroke beds at all times.

RCCG and TRFT have finalised a remedial action plan which incorporates the recommendations/ concerns from the Stroke Annual Peer Review, the recent clinically led visit and the requirements to improve performance against the national stroke indicators. Stroke Services is an area for inclusion in the Local Outcomes Framework Incentive (LOFI) Scheme for 2015/16.

11. CQUIN UPDATE

11.1 RDaSH

Final CQUINs have been agreed for 2015/16. Some final adjustments have been made to the Safeguarding CQUIN. Discussions are ongoing in conjunction with TRFT relating to the national CQUIN for Urgent & Emergency Care (UEC) – Improving diagnosis and re-attendance rates of patients with mental health needs in A & E.

11.2 Hospice

The Local CQUIN relating to patient outcomes is still being finalised.

11.3 TRFT

The Q4 CQUIN submission was received giving an overall achievement of -£464K for the year which was slightly above forecast. The areas of under-achievement were Pressure Ulcers, Dementia (FAIR), and Clinical Communications.

There has been significant improvement in the Pressure Ulcers in Acute Setting but unfortunately it was just above trajectory at year-end. The Community Pressure Ulcers indicator has also seen significant improvement reducing from 8.6% in April 2014 to 5.4% in March 2015 against a target of 4.08%. Work continues in this area and it remains a priority in 2015/16.

The Dementia FAIR indicator was on track for most of the year but unfortunately dipped off in February/March causing failure of target at year end. This remains a key area for the Trust and

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significant work is ongoing with expansion of the ‘Forget-Me-Not’ scheme and a new electronic survey for carers due to be introduced in 2015.

Continued work within Clinical Communications has seen vast improvements throughout the year and the minimum data sets seem to have embedded well across most specialties. The audits undertaken in Q4 still highlighted that there needs to be significant improvement in receipt of letters to GP Practices, although this had improved throughout the year. This remains high focus and will continue in local CQUIN indicators in 2015/16 with all specialties now being monitored through audit. It is hoped that the new electronic discharge summary delivery to GPs will significantly improve the 48 hour target.

The 2015/16 CQUIN scheme has been agreed with TRFT, there are four national schemes – Acute Kidney Injury, Sepsis, Dementia and Delirium, and Improving Urgent and Emergency Care. The CCG has agreed a further seven local schemes with the Trust, four of which continue from previous year with further stretch targets agreed. We are awaiting some baseline/threshold data prior to final sign off.

12. COMPLAINTS

12.1 TRFT

The number of complaints reported during February was 35. The Trust is on track to be under the year-end target of 600 with a year-to-date actual of 379 and only March figures outstanding.

12.2 Via RCCG

As reported at the May meeting four complaints have been received following a letter being sent out by a TRFT consultant regarding a CCG decision to limit the number of Botox sessions for Rotherham patients. One complainant states that as a result of not receiving the treatment he has had a urine infection which his GP suggested could be as a result of not receiving the Botox injection.

Update: As investigation is still ongoing with this issue, holding letters have been sent to the 4 complainants explaining that a letter of response will be sent to them as soon as the investigation is complete. Upon receipt of the holding letter, two complainants have indicated that they have either received treatment or treatment is imminent.

13. ELIMINATING MIXED SEX ACCOMMODATION

RDaSH/Hospice – No mixed sex accommodation breaches have been reported for either RDaSH or The Hospice YTD.

TRFT - RCCG have agreed with the Trust for the inclusion of Eliminating Mixed Sex Accommodation in the Local NHS Outcomes Framework Incentive (LOFI) Scheme for 2015/16. A proposal from TRFT is awaited on how this will be managed.

14. CQC INSPECTIONS

RDaSH – informed the CCG that the CQC will carry out their planned comprehensive inspection of the Trust and all its services during September. The date for the inspection is Monday 14th September – Friday 18th September 2015 with follow up unannounced visits during the following two weeks

Alexandra Nursing Home - Accommodation for individuals who require nursing or personal care, Dementia, Diagnostic and screening procedures, Physical disabilities, treatment of disease, disorder or injury, caring for adults under 65 years and caring for adults over 65 years. CQC Inspection published 1st May 2015.

CQC carried out an unannounced comprehensive inspection of Alexandra Nursing Home on 3rd and 4th November 2014 in which breaches of the legal requirements were found.

CQC carried out a focused inspection on 9 April 2015 to ensure improvements planned by the provider had been implemented to address the safety breach. CQC found that actions had been taken to improve safety for cleanliness and infection control. CQC completed a tour of the premises. They looked at bathrooms, toilets, bedrooms and the communal living areas. They found the home to be clean and tidy; however some areas of the home were in need of redecoration.

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CQC saw that a number of toilet floors had a gap around the bases of the toilet, making cleaning difficult and ineffective. This issue was raised with the registered manager who informed CQC that new flooring was on order for one shower room and three toilets. Evidence of cleaning schedules were made available and up to date. CQC will be review the rating for this service at the next comprehensive inspection in order to ensure that all improvements are made and that there is a plan to continue with the implementation to embed into practice.

Meadow View Nursing Home - Accommodation for individuals who require nursing or personal care, Dementia, Diagnostic and screening procedures, treatment of disease, disorder or injury, caring for adults over 65 years. CQC Inspection published 7th May 2015.

CQC carried out an unannounced inspection of Meadow View on 24th and 25th November 2014 with a number breaches highlighted. Individuals were not protected against the risks associated with the unsafe use and management of medicines, individuals did not receive care or treatment in accordance with their wishes and there was not always enough staff on duty to meet individual’s needs. During that inspection CQC also issued two warning notices for beaches in relation to regulations 9 (care and welfare) and 10 (assessing and monitoring the quality of the service provision) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

CQC undertook the focused inspection to confirm that Meadow View had made the improvements necessary regarding the warning notices issued. CQC did not address the other breaches during this inspection due to the provider been in the process of implementing their action plan. The report from CQC only covers the findings the two warning notices served in respect of care and welfare and quality monitoring.

At the time of CQC’s comprehensive inspection in November 2014 there was a new manager in place and they have now registered with the Care Quality Commission to manage the service and have legal responsibility for meeting the requirements of the law in line with the provider.

Individual’s needs had been assessed and care plans developed and reviewed since the last inspection. CQC observed that the care plans were been adhered to and that individuals needs were been addressed appropriately however it was recognised that the new practices still needed to be monitored closely to ensure they were fully embedded into practice.

Since the last inspection the registered manager has introduced new monitoring systems to ensure the quality of the service provision was monitored. CQC saw evidence of audits that had been regularly completed which included infection control, medicine management, accidents and incidents and care plans. It was also noted that the regional manager had completed monitoring of the service and there were action plans in place to ensure any issues/concerns that were identified were addressed and resolved.

15. ASSURANCE REPORTS

15.1 TRFT Update

A&E

The Trust started the financial year struggling against the 4 hour quality standard. However, May has seen improvement with the Quarter 1 (and YTD) position as at 17th May being 95.01% against target of 95%. This is a significant achievement for TRFT when performance against the quality standard continues to be a challenge both locally and nationally.

Cancer Standards

The Trust's performance against the quarterly cancer quality standards remains good with the validated position now confirming compliance against all standards for Q4. Performance has been consistent throughout 2014/15.

52 week waits

The Trust is on trajectory to meet its objective in relation to the 52 week wait recovery plan and this continues to be supported by NHS England. The formal contract query issued by RCCG will remain open until the pathway review is completed. NHS England is to provide a report on the access policy which will give both parties external assurance.

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2015/16 Contract Negotiations

RCCG and TRFT successfully reached agreement and signed the 2015/16 contract with TRFT on 31st March in line with national deadlines.

All of the contracts to which RCCG is an associate have now also been agreed and those not signed will be completed by the end of May 2015 at the latest.

16. CARE AND TREATMENT REVIEWS

There are currently no planned Care & Treatment Reviews. This applies to all Learning Disability (LD) patients in hospital irrespective of Provider.

17. WINTERBOURNE SUBMISSION

The CCG is now required to provide a weekly update on admission or discharge of Rotherham patients into an Assessment and Treatment Unit.

Week commencing

Admission Discharge Number in ATU Total number currently subject to Winterbourne

20th April 0 0 0 3

27th April 0 0 0 3

4th May 0 0 0 3

11th May 0 0 0 3

18th May 0 0 0 3

There are currently no patients in the locally commissioned ATU service (Sapphire Lodge). This has been the case since January of 2015.

Of the 3 noted above, 2 have active discharge plans which should support discharge in the very near future. However, both patients are potentially going to be discharged outside of the Rotherham locality. Following the implementation of ‘Who Pays – 2013’, discussions will take place with our counterparts in local CCGs. Early indications suggest that this will create additional delay which could be significant.

The RDaSH LD Inpatient service at Sapphire Lodge in Doncaster has one remaining (Doncaster) patient, who it is expected will be discharged following a review on the 26th May. After this point the service will not be accepting admissions. If an admission is required, then the service will co-ordinate admission to an alternative ATU. It is anticipated that this situation will remain for 6 to 8 weeks. After this point the position will be reviewed on a weekly basis. The service will seek to provide a more enhanced community service.

Sue Cassin – Chief Nurse June 2015

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Appendix 1 – Childrens Continuing Care Service User Feedback

SERVICE USER FEEDBACK – CHILDREN’S CONTINUING CARE

What is the survey about?

This survey is about Rotherham Clinical Commissioning Children’s Continuing Care

assessment process and treatment that you and your child received.

Your views are very important to us, to help find out how good the service was, and how

we can make it better.

It is up to you whether you want to take part in this survey -you do not have to.

Who is the survey for?

The questions are for parents or carers of children whom are unable to answer

themselves.

You do not need to say your name so please be honest. The answers you give us will

help us improve our service.

Filling out the survey

For each question please tick clearly inside one box. For some questions you will be

instructed that you may tick more than one box. Do not worry if you make a mistake;

simply cross out the mistake and put a tick in the correct box.

Questions or help?

If you have any questions or need help, please ask a member of the Children’s

Continuing Care team staff:

Team lead: Susan Stoker 01143054136 or 07773106975

Nurse Assessor: Sinead Eckhardt 01143051229 or 07773057596

Completed questionnaires can be returned to: Children’s Continuing Care

Yorkshire and Humber commissioning Support 722 Prince of Wales Road

Sheffield Darnall S9 4EU

Or emailed to: YHCS.SouthYorksChildrensContinuingCare@nhs.net

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Strongly agree

Agree

Not sure

Disagree

Strongly disagree

The nurse explained the process clearly

We were given time to talk about your problems

and needs

Our views and worries were taken seriously

We were treated with respect and dignity

We were given enough time to discuss your

condition and the impacts it has

We felt treated as an equal

Effectiveness of care/outcome of service

How well do you feel that your (care plan) meets your needs?

Do you think the service met the needs of your relative?

Shared decision making, self-management, involved in decisions regarding

care

Do you have a say about what you want for your future?

Did we let you ask questions?

Did we listen to what you had to say?

Did you know that you have a right to complain or provide a compliment

about any services you have received?

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Were you given the opportunity to be involved in any decisions about your

relative’s care?

Did this person take your views into account?

Access

Was it easy to get in touch with us?

The appointment times were good

The place we met was easy for me to get to.

Can you contact your Care Co-ordinator (or lead professional) if you have a

problem?

Does the client/carer understand the assessment process?

Did you receive enough information about the team when you were first

contacted?

General satisfaction with the service – an overall rating

How happy are you with the support you get?

What would make the support you get better?

How happy were you with the service?

Children’s Continuing Care

Was there anything you thought was really good about the service?

Was there anything that could have been better?

Thanks very much for your help!