Trust Board agenda papers

215 Pages·2016·3.22 MB·English

EAST SUSSEX HEALTHCARE NHS TRUST

TRUST BOARD MEETING IN PUBLIC

A meeting of East Sussex Healthcare NHS Trust Board will be held on
Wednesday, 10th February 2016, commencing at 10.00 am in the
St Mary’s Board Room, EDGH

AGENDA Lead: Time:

1. a) Chair’s opening remarks Chair 1000
b) Apologies for absence –
c) Making Every Contact Count 1115
d) Quality Walks

2. Monthly award winner(s) Chair

3. Declarations of interests Chair

4a. Minutes of the Trust Board Meeting in public held on 2nd December A Chair
2015 i

4b. Matters arising B Chair
ii
5. Acting Chief Executive’s report (verbal) CEO

6. Board Assurance Framework B CSec

QUALITY, SAFETY AND PERFORMANCE

Time:
7. Quality Improvement Plan Assurance C CEO/DN 1115
–
8. Quality Improvement Director’s Report (verbal) Assurance QID 1300

9. Speak Up Guardian’s Report (verbal) Assurance Ruth Agg

10. Performance and Finance report Month 9 (December) Assurance D

1. Patient Safety, Clinical Effectiveness & Patient DN/MD
Experience
2. Access, Responsiveness & Community COO
3. Workforce HRD
4. Finance DF

11. Safe Nurse Staffing Levels report Assurance E DN

East Sussex Healthcare NHS Trust
Trust Board Agenda 10.02.16
Page 1 of 3
12. Patient Experience Report Quarter 3 (October- Assurance F DN
December 2015)

13. End of Life Care Assurance G MD

STRATEGY
Time:
14. High Weald Maternity Pathway Approval I CEO 1300
–
15. Business and Financial Planning 2016/17 Update Approval J DF 1325

GOVERNANCE AND ASSURANCE
Time:
16. Emergency Preparedness Approval M CEO 1325
-
17. Board sub-committees: Assurance N Comm 1345
a) Audit Committee Chairs
b) Finance and Investment Committee
c) Quality and Standards Committee
d) Remuneration Committee
e) Terms of Reference for People & Organisational
Development Committee

ITEMS FOR INFORMATION
Time:
18. Use of Trust Seal O Chair 1345
-
19. Questions from members of the public (15 minutes maximum) Chair 1400

20. Date of Next Meeting: Chair
Wednesday, 13th April, Lecture Theatre, Education Centre, Conquest

21. To adopt the following motion: Chair
That representatives of the press and other members of the public will
be excluded from Part 2 of the meeting having regard to the
confidential nature of the business to be transacted, publicity on which
would be prejudicial to the public interest
(Section1(2) Public Bodies (Admission to Meetings) Act 1960)

David Clayton-Smith
Chairman

25th January 2016

East Sussex Healthcare NHS Trust
Trust Board Agenda 10.02.16
Page 2 of 3
Key:
Chair Trust Chairman
CEO Chief Executive
COO Chief Operating Officer
CSec Company Secretary
DCIS Director of Clinical Information &
Strategy
DF Director of Finance
DN Director of Nursing
HRD Director of Human Resources
MD Medical Director
QID Quality Improvement Director

East Sussex Healthcare NHS Trust
Trust Board Agenda 10.02.16
Page 3 of 3
East Sussex Healthcare NHS Trust

Date of Meeting: 10th February 2016
Meeting: Trust Board
Agenda item: 1c i
Making Every Contact Count (MECC) - Awareness and
Subject:
Update
Penny Walker, MECC Project Lead for ESHT
Reporting Officer:
Liz Fellows, Assistant Director of Operations

Action: This paper is for (please tick)
Assurance X Approval Decision
Purpose:
To raise awareness of the project within the Trust, of collaborative working between ESHT,
Hastings and Rother CCG, Public Health ESCC, and healthy life style providers.

Introduction:
Many people in the Hastings & Rother area have significantly worse health outcomes than the rest
of England. The aim of MECC is to create a healthier population; reduce NHS and social care
costs; improve health outcomes and reduce health inequalities. This is achieved through enabling
change by reaching as many people as possible with key health messages and signposting them
to support services.

Analysis of Key Issues and Discussion Points Raised by the Report:
Through collaborative working with agencies, across the local health and social care economy, the
Trust has launched a pilot to educate staff to adopt the principle of “making every contact count”.
This is achieved through conversations, advice and where appropriate onward referral to support
services such as smoking cessation.

The programme is fully funded by Hastings & Rother CCG and currently each referral attracts an
incentive payment.

The pilot stage has been successful and work is now underway to develop a business case to
extend the programme wider in 2016/17.

Benefits:
If all public facing workers are provided with the confidence and skills to make every contact count
it will support healthier lifestyles and reduce inequalities.

By raising awareness the programme supports staff health & well being and the Occupational
Health team are part of the project team.

Risks and Implications
Operational pressures and vacancies restrict the availability of staff to attend the study sessions
Trust Board 10/02/16
Agenda item: 1c

Sustainability of programme – currently in early stages and needs continued and wider promotion
to maintain awareness.

Assurance Provided:
This programme adopts the principle of collaborative working across health and social care in line
with the East Sussex Better Together agenda.

Proposals and/or Recommendations

Support and commitment from the Trust Board for continued roll out into 2016-2017.

Outcome of the Equality & Human Rights Impact Assessment (EHRIA)
What risk to Equality & Human Rights (if any) has been identified from the impact
assessment?

It was identified that due to the nature of the pilot being only currently focused at the Hastings and
Rother CCG area that there was an inequality across the Trust. The health needs for those living
in the Hastings and Rother CCG area outweigh the inequality of those not being involved currently.

In addition negotiations are underway with other CCGs to engage in the programme.

For further information or for any enquiries relating to this report please contact:
Name: Penny Walker Contact details: [email protected]
Mob:[phone]

Making Every Contact Count (MECC)
Page 2 of 7
Making Every Contact Count

What is Making Every Contact Count (MECC)?
The aim of MECC is to create a healthier population; reduce NHS and social care costs;
improve health outcomes and reduce health inequalities. This is achieved through enabling
change by reaching as many people as possible with key health messages and signposting
them to support services.
Through education and training, public facing workers are encouraged to adopt the principle
of “making every contact count”. The education they receive will support workers to start a
healthy conversation, either in the form of brief advice or a more enhanced brief intervention,
supporting clients to access relevant services. MECC is applicable across all age groups
and involves many aspects including:
• Stopping smoking – in all age groups, including pregnant women.
• Fuel, Poverty and Health awareness.
• Physical activity - Healthy Weight
• Alcohol awareness - Sensible drinking
Making Every Contact Count within East Sussex Healthcare NHS Trust is a collaborative
approach for success, working with Hastings and Rother CCG, Public Health, East Sussex
County Council and healthy lifestyle service providers.

Why is it important?
People cannot be forced to change, but by using opportunities to raise the issue of a healthy
lifestyle in a non-threatening way, people’s awareness, confidence and motivation to make
changes to improve their lives may occur. Access to local health and lifestyle services may
also be enhanced.
The responsibility to support individuals to think and act more healthily wherever possible,
and guide them to any further help does not sit with a particular professional group or
workforce. It embraces many roles as it emphasises prevention of problems and early
intervention.
Having a good MECC conversation is about:
 Spotting opportunities to talk to people about their wellbeing. It does not mean every
time you meet an individual a healthy lifestyle conversation will take place; it is about
Let’s Make Every Contact Count – All You Have To Do Is Ask
Developed by Penny Walker – MECC Project Lead. Contact [email protected] or
mobile [phone]
using the appropriate cues and opportunities to raise the issue of health and well-
being.
 Being able and confident to start a conversation about a wellbeing matter.
 Being able and confident to deal with questions and issues as they arise.
 Assessing the motivation a person has to take action to improve their health and/or
wellbeing.
 Providing information.
 Encouraging people to take actions to help themselves.
 Signposting to relevant services when required.

What does it mean for our organisation?
All our patient facing staff have conversations with members of the public every day and
some of these maybe about difficult or sensitive subjects. Encouraging conversations about
health is the underpinning objective of MECC. This includes helping organisations and their
staff develop skills in relation to:
 Understanding the issues affecting wellbeing
 Engaging in a good MECC conversation – this includes acknowledging that not all
contacts are MECC appropriate.
 Giving brief advice, encouraging self-care and signposting to services.
 The MECC program enables workforces to develop the skills and confidence to:
 Competence and confidence to make every appropriate contact count.
 Knowledge about local services and how to signpost people to enable them to
access the right support.

The ESHT Call to Action
Many people in the Hastings & Rother area have significantly worse health outcomes than
the rest of England as documented in the Reducing Health Inequalities in Hastings and
Rother CCG (H&R) area report (2014). Below are a few of the statistics that are outlined in
the report:
 H&R CCG have a population of 183,000, and contain the seven most deprived
council wards in East Sussex.
Let’s Make Every Contact Count – All You Have To Do Is Ask
Developed by Penny Walker – MECC Project Lead. Contact [email protected] or
mobile [phone]
 29% of children in Hastings and 19% in Rother live in poverty.
 Men in the most deprived areas of Hastings are expected to live 11 years less than
those in other areas of the town – the biggest gap in the South East of England, life
expectancy for both men and women is lower than the England average.
 Hastings is significantly worse than England for the percentage of women smoking in
pregnancy, percentage of adults smoking, percentage of people with a long term
condition smoking, general practice recording of smoking status of patients, smoking
attributable hospital admissions and smoking attributable deaths.
 Hastings has significantly higher percentages of people with bad or very bad health
compared with the rest of England with high rates of long term illness, disabilities,
cancer, lung disease and heart problems.
 Hastings is significantly worse than England for alcohol attributable mortality for
males, alcohol specific and alcohol attributable hospital admissions, admissions due
to alcohol related harm.
In the summer of 2014, H&R CCG launched an action plan to tackle poor health in the area,
including a call to action to implement MECC in all services that engage with the public.
The CCG are funding the project within ESHT and are fully committed to its roll out into
2016-2017. At present they are offering additional financial incentives for every referral
made to any of the healthy life style providers to support the organisation in the roll out.

Progress to date in the MECC pilot project.
1. ESHT have established a project board and appointed a project lead to oversee a
pilot programme for the implementation of MECC.
2. Competencies developed by the Kent Surrey and Sussex MECC project manager,
are now been recognised as the national tool for MECC education and the training
has been adopted to deliver education within ESHT. The competencies meet the
original MECC competences from 2009 and have been adapted to use skills for life
for health professionals, including awareness of the local and national need for a
healthier population, how to have a conversation, recognising an opportunity to have
a conversation and taking this forward with the confidence to refer staff to the outside
service providers and documentation.
3. Staff groups for the pilot were selected utilising experience from elsewhere in the
country and the priority areas in H&R e.g. reducing smoking during pregnancy. The
intention was to target groups within the nursing and midwifery workforce but this
was later widened to Allied Health professionals and Health Visitors.
4. Forty staff have been trained in the first phase of the pilot (November/December
2015) from a range of wards and departments based at the Conquest Hospital.
Let’s Make Every Contact Count – All You Have To Do Is Ask
Developed by Penny Walker – MECC Project Lead. Contact [email protected] or
mobile [phone]
5. A further fourteen days have been booked with the outside training provider Zest
Consultancy for the end of January and the whole of February to capture the
remaining staff for the pilot stage.
6. Training days also include input from service providers such as:
 QUIT51 – smoking cessation service
 STAR- the alcohol and drug recovery service
 Re:balance - the weight management service
 Health Trainers
 Active Hastings and Active Rother
 Winter fuel and poverty service
7. Work has started on developing e referral, using existing technology to facilitate
speedy referral and an effective audit trail. There is now an e referral form for
QUIT51 on e-searcher, and the alcohol and drug recovery service STAR referral form
is also going live in February via e-searcher, others service providers are developing
referral forms to speed the referral process for individuals.
8. The project lead has presented at the “Start Well, Live Well, Age Well – Working
together for a healthier East Sussex” event in Eastbourne in December to
representatives of a wide range of organisations in East Sussex.

Performance
There is very little baseline data available to provide a benchmark. The service providers are
being tasked with refining their record of referrals and this will be used as a baseline to drive
the programme in 2016/17.
In the first month of programme the following referrals have been made:
Service Number of conversations/referrals
QUIT 51 13 (12 via e referral)
Re:balance 11
Additional MECC conversations, no 4
referral

Next Steps
Let’s Make Every Contact Count – All You Have To Do Is Ask
Developed by Penny Walker – MECC Project Lead. Contact [email protected] or
mobile [phone]
1. Continued engagement with staff to undertake training.
2. Continued development of communication strategy for a wider audience
3. The appointment of MECC champions from areas where staff that have attended the
MECC training in the first phase, this concept will be rolled out across all areas that are
involved in the training.
4. Regular meetings will be arranged to support those who have attended the training on
either a one to one basis in their clinical environment by the project lead or by attending
champion meetings.
5. Fourteen days training set for the last two weeks of January and the whole of February
2016. Outside healthy life style providers are attending with stands and information
over a working light lunch, for staff to review and discuss services.
6. MECC training has been adapted for maternity staff to incorporate MECC training and
the requirements for revalidation. Maternity staff already undertake health promotion
and have training as a core part of their role.
7. Monitoring of conversations that are undertaken by those trained that may not lead to a
referral along with those conversations that do lead to a referral.
8. On-going evaluation of training and referral rates.
9. A business case to support the roll out of MECC across all relevant staff groups,
supported by H&R CCG.
10. Engage with other CCGs regarding the potential expansion of the project across all
local CCGs.
11. Ongoing collaborative working with Hastings and Rother CCG, Public Health, ESCC
and all healthy life style service providers.

Making health improvement everyone’s business.

Let’s Make Every Contact Count – All You Have To Do Is Ask
Developed by Penny Walker – MECC Project Lead. Contact [email protected] or
mobile [phone]