Agenda and minutes

It was confirmed that all items on the agenda would be considered in public.

Agreed as an accurate record.

For this witness session, the Committee was provided with the perspective on hospital discharges from patients (Healthwatch) and from Hillingdon Hospital and Central North West London NHS Foundation Trust.

Healthwatch Hillingdon

Graham Hawkes, Chief Executive Officer of Healthwatch attended the meeting and provided Members with a summary of the recent review which had been carried out by the organisation into hospital discharges from Hillingdon Hospital.

The project aimed to gain an understanding of the discharge process from the perspective of the patient. It looked at what went well, and what did not go well.

The project focussed on adults over the age of 65 and their experiences of being discharged from Hillingdon Hospital.

The methodology of the review was split into three stages. Stage 1 involved 172 patients being interviewed and completing a survey on 17 different wards at the Hospital. Dependent on the condition of the patient, patient's advocates completed the survey.

Stage 2 involved interviewing patients 30 days after being discharged, in which they were asked for their experience of the discharge process and whether their post discharge care had been adequate. 52 discharged patients/advocates completed the second survey.

At Stage 3, Healthwatch met with over 20 organisations who commissioned, or provided care services within hospital and the community for the over 65s in Hillingdon. This stage helped the review to identify and understand the processes and procedures involved in hospital discharges, and the factors, barriers and enablers which contributed to providing patients with a safe transfer from hospital to being cared for, out in the community.

The Committee was informed that generally the results showed that the over 65s had expressed an overwhelming feeling of pride in the NHS and hospital discharges. However, it was found that staff were working under intense pressure and that care could not always be delivered to the required standard.

The review's findings were summarised into three categories:

·         Communication and Information

Communication between patients / carers and health professionals and the information provided, was sometimes poor. Reference was made to patients being unable to speak to doctors, patients not remembering what had been told to them, patients not knowing which medicines to take, who was coming to see them at home and how to arrange a private care home placement or a care package.

Discussion took place on how this could be improved and whilst it was acknowledged that hospitals were very busy, it was suggested that providing clear written information for patients / carers, would improve communication and improve outcomes for patients.

Details of the review's recommendations were reported which included updating the Trust's "Working Together" booklet, to include a Patient Journey booklet which provided information for patients / carers.

·         Process and Procedures

There was a marked difference in the discharge procedures on each ward which meant there were discrepancies on how patients were treated in terms of being prescribed medication and how transport was processed. Examples were given on how some patients had been left many hours  ...  view the full minutes text for item 33.

Members were provided with a progress report on the Committee's Stroke Prevention review.

The Committee noted the information which had been provided in the report on the work which was being carried out by other public health authorities. It was noted that Hillingdon was ahead of other authorities in terms of initiatives for stroke prevention.  

The Director of Public Health reported that for staff within Hillingdon, there were a number of initiatives which were used. There was a weight management programme, smoking cessations sessions and health checks. Reference was made to the possibility atrial fibrillation detection, and self-help health checks being made available for staff.

The targeting of staff could be an opportunity for the Council to promote stroke prevention to the wider population of the Borough.

Reference was made to the visit to Hillingdon Hospital's Stroke Unit by Councillor East who provided the Committee with a report on her findings. The Committee thanked her for the information provided.

Discussion took place on suggested recommendations for the review and officers were asked to take forward the following suggestions, and include them in the final report for the review:

1. That Officers be requested to develop the universal wellbeing offer to prevent stroke and for this to include smoking cessation, physical activity and health - (Primarily with the Wellbeing Team)

2. That Officers be requested to develop a campaign on stroke risk and stroke prevention using multiple channels which is sensitive and appropriate.

3. That the Council, working in partnership with the Hillingdon CCG, be requested to promote and develop health checks as a vehicle for identifying residents at an increased risk of stroke.

RESOLVED –

1. That officers be asked to update the previously circulated draft final report with the information above, and submit the report to the next meeting of the Committee for approval.

The Committee asked that a report on the Integrated Sexual Reproductive Health Services be brought to a future meeting of the Committee  

Noted.

Members noted that the Chairman of the Adult Safeguarding Board would be invited to attend the Committee's meeting on 21 February 2017 to present the Board's Annual Report. 

Discussion took place on possible review topics for the Committee and the following areas were raised:

·         The Welfare Benefit Reforms and the Changes being Implemented, eg the new benefits cap?

·         Home Ownership in the Borough - the success of it.

·         Right to Buy Scheme.

·         Asylum seeking children in the Borough.

·         Loneliness.

The Chairman of the Committee agreed to discuss the potential review topics with officers and at the next meeting of the Committee, a presentation would be given on the preferred option.

Noted.