ASSOCIATE HOSPTIAL MANAGERS COMMITTEE MEETING
Unconfirmed Minutes of Meeting
Held Thursday 22nd September 2016, 2pm Training Room 5, the Lodge, Wickford
Present:
Nigel Leonard
Steve Currell
Karlien Saayman
Debbie Radley
Eileen Greenwood
Roy Sanderson
Jo Hixon
Ray Newman
Iain Burns
Olwen Williams
Sally Chapman
Richard Boyd
Mohan Kurup
Jeffery Conway
Patricia Wilbourn
Joan Holden
Alex Kaye
Joseph Soosai
NL
SC
KS
DR
EG
RS
JHi
RN
IB
OW
SCh
RB
MK
JC
PW
JH
AK
JS
Executive Director Corporate Clinical Governance
Non-Executive Director
Consultant Social Work Practitioner/MHAO Lead
Mental Health Act Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
Associate Hospital Manager
1. WELCOME & APOLOGIES
SC welcomed all present.
Apologies received from: Dawn Hiller, Lisa Rodbourn and Michael Batten.
2. DECLARATIONS OF INTEREST
No declarations of interest were made.
3. RECRUITMENT & RESIGNATIONS
No recruitment or resignations.
4. MINUTES OF THE LAST MEETINGS HELD THURSDAY 17TH JUNE 2016
The minutes of the last meeting were reviewed and agreed by all.
5. MATTERS ARISING (ACTION LOG)
AHM Website page has been set up; some AHM’s are having problems accessing this.
Action: DR to resend to AHM’s
Payslips all are now receiving them, although EG’s slip are still going to Basildon Mental Health
Unit.
Action: DR to contact payroll
RB and JS had pension taken out of their pay, SC informed that he will need to opt out of the
pension scheme
Action: DR to contact payroll
OW, AK and EG would like hard copies of the MHA presentation that was previously sent
electronically.
Action: DR to forward
DVD/Online link requires amendment, once SC has had it amended DR will forward to all
AHM’s
Action: SC to get amended completed Dr to then send to AHM’s and upload to AHM
Webpage
Tax on travel and letter of agreement – NL the Trust has acted in good faith based on
information given by HMRC. Following numerous discussions with HMRC new advice has
been issue in that AHM’s do not have to pay tax on their travel expenses. The letter of
agreement has been amended by HR to reflect this advice.
JH and IB noted that the new letter of agree doesn’t state the difference in payment for sitting
as a Chair which is £60 per session.
Action: NL to take back to HR for amendment
PW asked if the new letters that have been issued be signed, NL informed not at present but to
wait for the letter to be amended and resent out.
AK asked for clarification whether travel expenses are earnings or reimbursements.
Action: DR to get clarification from Finance Department
IB asked if you were at hearing at one location and then went to a different location could you
claim travel costs for the second journey as he had been informed that he couldn’t. It was
confirmed that he could claim all journeys.
SC said that he was aware that the process to get the tax on travel has taken a time but the
Trust wanted to ensure that we had the correct information from HMRC which took numerous
communications between the finance department and HMRC.
NL informed the meeting that a representative from the finance department and HR will be
invited to the next meeting to answer any questions that the AHM’s may have.
Action: DR to invite KK & DP to next meeting
SC asked if any of the AHM’s had/received letters from the HMRC regarding their role as an
AHM could they please forward to SC (personal information redacted).
JH wanted to share with the meeting that Basildon car park had increased the parking fees
from £3 to £5.
NL informed the meeting that following the completion of the works outside The Lodge that
there are increased numbers of disabled parking bays, with two priority parking bays that can
be used.
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KS stated that the number that was originally quoted only reflected the number at the front of
The Lodge and didn’t include the numerous spaces at the back of The Lodge.
AHM sitting on hearings – IB ask if a spread sheet had been produced KS replied that it had,
IB said he thought that the it was going to be to distributed at the meeting, KS replied that she
had reviewed the spread sheet and it showed that all AHM’s have had a similar number of
hearings, SC asked if he could be sent a copy of this.
Action: KS to forward spreadsheet to SC
KS stated that the AHM’s need to respond to the email giving dates of hearing promptly to the
MHA office their availability, the MHA office have inform KS that they are having problems with
getting panels for hearings at Basildon Mental Health Unit.
AK informed that she parks in the disabled parking spaces at BHU but has seen an increase in
non-blue badge users using these spaces. There are also problems if the hearing is in the
afternoon as it takes so long to get out of the main car park, SC said he parks in the town and
walks in.
PW asked if hearings could take place in the mornings, KS replied that RC availability dictates
when the hearings are.
6. HOSPITAL MANAGERS REVIEW HEARINGS
SC asked EG if she would give a summary of a recent Bar Discharged hearing that she
chaired as a learning experience for the AHM’s.
7. FEEDBACK FROM MENTAL HEALTH & SAFEGUARDING COMMITTEE MEETING
KS informed the meeting that the July meeting had been cancelled due to attendance issues.
The next meeting is to take place on 29/09/16.
Any assurance report from the AHM meetings that go to the MH & S Committee will be put
onto the new AHM page on the SEPT internet site. KS asked if anyone had had a look at the
page. JH said she had accessed it and felt that it need more information for the experienced
AHM’s, SC said that this was a work in progress and more information will be added as felt
appropriate he asked that AHM’s let DR what they would like on the site.
Action: AHM’s to let DR know what sort of information they would like to see on the site.
Some of the AHM’s could access the site, DR to resend the link.
Action: DR to resend link
8. CQC VISIT & MHA AUDIT REPORT
JC raised his concerns that the themes as the same ones that they used to pick up through the
AHM scrutiny visits. He asked if anyone looks at these now they are not done by the AHM’s,
any why was nothing being done about the recurrent themes.
KS responded that this can be due to staff changing and not fully aware of what needs to been
complied with.
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KS informed that the themes related to audits undertaken back in Q1 and that since that time
an external audit around those themes identified had been undertaken in June and that we
were compliant in many of those areas.
SC informed that the MHA office undertake regular audits. NL said that the themes were
discussed and the Operational Pre Meeting with senior representatives from the Operational
and Medical Directorate and assurance is then given to the Mental Health & Safeguarding
meeting.
IB asked if the Trust did mock CQC visits, the Trust did them last year in preparation for the
Trust wide CQC visit. IB said that he is aware that in other Trusts the AHM’s assist in the mock
CQC visits, DR informed that the compliance team asked for representative from all areas to
assist in the mock visit this would have included AHM’s. JH informed that the governors
undertake mock CQC visits.
9. MENTAL HEALTH ACT ACTIVITY
KS informed the meeting that the figures are sourced from the performance department.
KS said there has been a big increase in detentions, residential homes are sending
challenging clients to A&E for MHA assessments.
A new AMHP hub has been introduced which is managed by two senior AMHP’s who screen
and filter requests looking at the least restrictive options available.
SC asked KS if there had been a reduction in section 136’s since the introduction of the triage
nurses, KS informed no, as of the 136’s that are brought into the 136 suited 60% are
discharged with no further action, SC said that as they has been an increase in 136’s that the
figure would have been lower if the detention rate had stayed the same.
SC explained the role of the triage nurse to the meeting.
10. ANY OTHER BUSINESS
EG enquired if Mayfield was closing, NL responded that this is a CCG initiative to merger
Mayfield and Meadowview together due to low occupancy, this will free up one ward for a
urgent care centre which will be a physical health facility for Thurrock residents.
JH and JC raised concerns about the completion of care plans, they don’t always evidence that
the patient has been involved in the planning of the care plan and that they aren’t always
reviewed in a timely manner. PW stated that the care plans are an important document for
gaining up to date information.
NL stated that we need to keep the pressure on staff to ensure compliance with the completion
of care plans; this issue is addressed by the audit that is undertaken and report to the
Operation pre meeting where this would be discussed.
KS and DR are meeting with the newly appointment practice educating lead who attends the
wards to facilitate training, we will inform her of the concern regarding completion of care plans.
Action: KR to raise the completion of the care plans with the practice education lead
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A discussion took place around the importance of risk assessments, JH said that the HCR20
are extremely helpful and give a lot of detail which is not always present in the reports. SC
said that the lack of sufficient information around risk within the report should be addressed in
the feedback forms as this a way that we can monitor trends and this can be raised with the
Medical Director.
JH and KR will be attending the annual doctors meeting to talk to the doctors about the
importance of have reports that give sufficient information for AHM’s to make informed decision
in relation to using their power of discharge under the Act.
AK said that when she received reports that she felt didn’t have sufficient information she
would ask KR or WC if they could get the doctor to update the report.
JH gave an example of a recent hearing where the locum doctor hadn’t addressed the health
criteria in that he was referring to the health criteria with a physical illness.
SC said that he had had a hearing where the RC didn’t attend and a STC doctor attended,
although the STC doctor gave excellent evidence, SC said that this was the first time he had
come across the RC not attending, JC questioned if the hearing should be adjourned if the RC
didn’t attend, SC asked RS for his view as he is a Tribunal Panel member, RS responded that
the Tribunal requires that a doctor that knows the patient should attend and that it is not always
the RC.
SCh asked what should happen if the information available wasn’t up to date, should the
hearing be adjourned, SC said that you have to take each case on an individual basis, can you
gain the information by asking to see the patients notes, talking to the professionals, but if you
can’t gain the information you feel you need them an adjournment may be necessary.
EG wanted to inform the meeting of how supportive Kevin Russell and Wendy Cracknell are at
hearings.
RN shared a recent experience where a RC had reported that he was concerned about the
health and safety of a patient if they needed to be restrained, he had wanted to report this on
the decision form as a concern but the rest of the panel felt that this may be seen as a criticism
of the staff and didn’t want this written as they didn’t have the knowledge of restraint and so
could say whether the restraint was a concern or not. SC said that they had recent had a PV
trainer attend the directors meeting to give some demonstrations of the different ways to
restrain a patient, he said that it was excellent and thought that the AHM’s would find it really
helpful to see how this is done.
Action: PV trainer to be invited to give a demonstration at one of the training sessions
for the AHM’s
SC informed the meeting that he had completed an audit of the decisions, 12 decisions had
been audit and all were of a good standard and gave good evidence for using your powers
appropriately, the decisions were informative. Just to note that in the question around MCA,
this means has the RC considered or not to use the MCA.
JS said that he was having problems receiving his reports as he is out most of the day and the
reports are going to the Royal Mail sorting office and they recently lost the package. It was
suggested that JS has the reports emailed to him, password protected, he said that would be
better, RS asked if he could also have them email rather than posted out to him.
Action: DR to arrange with the MHA office to email reports to JS & RS in future.
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SCh asked if she could have a copy of the MAZE, the current MAZE hasn’t been update
following the revised Code of Practice so wouldn’t be helpful.
SC wanted to inform the meeting that RN has just published a book titled “Finally Laid to Rest”
and that he felt the AHM’s would find it interesting.
IB raised the issue of peer appraisal and that the appraisal training that some of the managers
had in that is wasn’t focused or suitable to the AHM’s.
Action: SC and DH to discuss options
11. MEETING EFFECTIVENESS – ANY RISKS TO BE ESCALATED?
None raised.
12.
DATE AND TIME OF FUTURE MEETINGS
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Thursday 8th December 2016 - 09:30 to 12:30
Thursday 16th March 2017 - 14:00 to 17:00
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