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Agenda item 09 Enclosure KPCT/07/20

KIRKLEES PCT Report To:

PCT Board

Title:

Provider Services Updates reports

FOI Exemption Category

Open

Lead Director:

Robert Flack Director of Provider Services

Author: Key Points to Note:

Gwen Ruddlesdin Deputy Director of Primary Care The attached reports provide updates for services provided across the PCT. These reports have been compiled by the Service Managers to give information on progress, good practice, successes and issues within each area of work.

Budget Implications:

N/A

Risk Assessment:

District Nursing staffing, in particular, has been affected by long term sickness and maternity leave. However, managers have worked to minimise risk and to maintain safe and effective services.

Healthcare Benefits

Managers in the Directorate are working together to develop consistent approaches to service provision across the PCT. In the South part of the PCT, work is continuing to develop Supporting Families teams in accordance with Every Child Matters.

Staffing Implications

N/A

Sub Group/Committee:

N/A

Recommendation:

The Trust Board is asked to receive and note this report.


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Locality: Ashbrow, Greenhead and Lindley Name: Kath Evans and Angela Horner Locality Managers Tel.no. 01484 34 451

Email address:- kath.evans@kirkleespct.nhs.uk angela.horner@kirkleespct.nhs.uk

1. Operational Issues

District Nurse Teams vacancy situation has started to be resolved by transfer of staff from North of patch. Sickness and maternity leave remains high. School Nurse service restructured and reconfigured into localities in line with LA boundaries. Ongoing visits and contacts with Head Teachers and L.A. partners to explain relevant changes and receive /respond to feedback regarding any issues impacting on the needs of children and young people and services. Medical Entry Clinic relocated to PRCHC due to low uptake at HRI – uptake of service now improving Health Visiting teams in process of reconfiguration , and corporate working in line with key drivers and LA boundaries and Childrens Centres. Implementation plan for service changes across Huddersfield developed. Plans to meet with LA partners regarding opportunities for co-location in local Childrens Centres. Paper being presented to S.M.T. Interpreter services now in provider services and currently with Greenhead and Lindley locality team Diabetes service continues to run with a vacancy.

2. Partnership Working

One practice in the locality is taking part in Wave 2 of the PBC Collaborative and a further 3 practices are participating in Wave 3 All practices are participating in the Huddersfield Central Commissioning Consortium and are taking part in the Practice Based Commissioning DES as part of that consortium. All practices in Greenhead & Lindley are now undertaking Choice and Booking and are therefore taking up the DES The executive, comprising five GPs and five practice managers, for the Consortium has now been elected and two GPs and one practice manager from Greenhead and Lindley are on the Executive. Following approval of the business case for a local enhanced service for care homes, all practices within the locality will be offered the opportunity to participate in this LES from January 2007 for a one year pilot period initially.


3 practices in Greenhead and Lindley have decided not to undertake Choice and Booking and are therefore not taking up the DES. Whitehouse ongoing review of the service provision at the Whitehouse and a briefing paper presented to Mr M Potts. Meeting planned in January for decision regarding future options for this service

LAC –developments of Joint Health Sub Group. First Health Sub Group meeting September. Progression of Huddersfield North Children’s Centre Locality Planning. Development of locality wide plan and micro planning of Children’s Centre activities. On going discussions re: co location of Health staff at CC sites. Plan to meet with Head of Localities re corporate approach. Assessment of wider public health inclusion in planning. Developing brief for Infant massage programme, potential to pilot in locality and roll out. Joint locality approach with Midwifery services Support for Health Trainers programme, facilitating part of induction programme, establishing links to local providers and networks. Ongoing development of Healthy Living Alliance, (3 BLF HLC’s) constitution agreed, Executive Board membership almost complete. Development of matrix to plan joint working programmes, continued involvement in Paddock Pathways to Health management to develop sustainability strategy for some elements. Early planning for health event in Lindley area. Raise an Issue – joint development of issue referral request scheme to sit in KMC and Health. Briefing being developed for NR locality group – possible pilot in the locality if funding available.

3. QOF Update (as required)

QOF visits being undertaken in the locality.

4. Operational Development Plans

Community nursing developments continuing in line with needs in localities and provider review. Reviewing reception services PRCHC reception staff Plan to review child health clinics held at PRCHC Risk Assessment completed for Medical Entry Clinic (Operational staff/PH Dev worker) – awaiting feedback from Risk Management team Discussions around locality based service support for children and family maternal mental health delivery.


5. Financial issues

Continuing to work within budgets set.

6. Anything else, relevant or important

PRCHC Site issues – full assessment of site ongoing re health and safety issues being led by Chris Bedford. Awaiting feedback from this report Further full assessment of health and safety issues at the Whitehouse Centre further to serious incident. No space at Fartown health centre to appropriately meet the needs of the community matrons. Cleaning issues at Fartown health centre to be resolved.


LOCALITY: Batley Locality Name: Caroline Mullins Locality Portfolio Manager Tel.no. 01924 351570 Mob.no. 07904653332

Email address: caroline.mullins@kirkleespct.nhs.uk

1.

Operational Issues

The district nursing team continues to work with other teams across the PCT to ensure safe levels of cover for patient care. The team currently have vacancies: 2.6WTE Long term sickness: 2 staff are on phased return to work. Maternity leave: 1.0WTE The team use capacity and demand to look at the needs of the service and staff required. Primary Prevention Nurse on long term sickness has handed her notice in. The PPN worked one day in a GP practice. The PPN team are looking at current activity across Kirklees North in order to redistribute resources. The 2 Health Start Workers fixed term contracts funded through Sure Start, finish end March 2007. The team have been an invaluable resource within supporting families’ in Batley. Their role has evaluated well with families and professionals. Funding is currently been sought for the 2 staff.

2.

Partnership Working

The school health practitioners working closely with Batley Girls High School have secured funding from the Healthy School budget to improve the medical room at school. The drop in session for pupils has now been extended due to increased demand. A joint adventure between school health practitioners and the drugs worker team have developed a programme for vulnerable young women at Batley Girls High School. The team have consulted with the young women and developed a programme that includes: peer massage, relexology, guided imagery, mini manicure, health advice and gym induction. The venue has been negotiated with Howden Clough Sports Centre which is next to school. The programme starts at 3pm to 4:30pm as requested by the young women. The course is for 6 young women over a 5 week period and will be evaluated fully.


3.

QOF update (as required)

N/A

4.

Operational Development Plans

Newly developed Baby Chums group. The group is facilitated by two community nursery nurses at Batley Health Centre. It focuses on parents in Batley with babies from birth until they are mobile. The team give advice and support on topics such as diet, sleep, crying, play, development and safety. The group is led by parents and has developed a newsletter to share ideas and opinions which parents feel are important. District nursing messaging service run through Social Services Information Point has evaluated well with the patients, district nursing team and G.P. practices. The service has now been rolled out to Spenborough Locality. Batley supporting families’ team have developed the case manager role to support and co-ordinate activity within the teams. The Health Visiting teams have a case manager for each of the 3 geographical areas and one case manager for the school health practitioner team. Staff are entering data on to the epex system and analysing the data provided to ensure accuracy. The case managers will look in depth at the data over the coming weeks and advise on changes in service if required.

5.

Financial issues

Lease car allowance continues to affect budget as there is no allocation attached. Equipment e.g. vac therapy for district nursing services continues to over spend. Overall budget at present on balance.

6.

Anything else, relevant or important


LOCALITY: Crosland Moor, Almondbury, Newsome, Dalton Name: Joan Booth Locality Manager Tel.no. 01484 345602 Mob.no. 07977 553003

Email address: joan.booth@kirkleespct.nhs.uk

1.

Operational Issues

Long term sickness remains a challenge, with 3.5 WTE on long term sick in district nursing. The newly re-configured district nurse teams at Mill hill have swapped rooms so that they are in the larger ones, to enable them to work together more effectively. The health visitors and school nurses at Mill Hill are now sharing a large room as a first step to working more closely together to support families. The Newsome district nursing team is still working across two sites until suitable premises can be found to house the bigger team. The Crosland Moor health visiting team does not yet have a new base – options are being considered This situation will be eased with the development of a provider services estates strategy forward planning as to which of our current buildings we would wish to keep and when to give notice on rental agreements

2.

Partnership Working

Health visitors in Dalton are part of the local health group – working with partners in the area to address local needs. Health visitors in Newsome are working closely with Newsome Next Generation who are funding their jungle trail work with three year olds. Many staff have been asked to complete a questionnaire about the new council Gateway workers scheme

3.

QOF update (as required)

Two practices have had QOF visits with a third visit planned


4.

Operational Development Plans

Health visitors working in the Crosland Moor area are piloting information sharing and a common assessment framework to support families across agencies. The locality manager and a colleague has met with the Children’s Centre Manager to look at getting strategic sign up to co-location

5.

Financial issues

Funding will be required for 2007/2008 to backfill the health visitor who is a PEC member in order that health visiting services can function adequately

6.

Anything else, relevant or important

Staff are looking forward to agreement on service specifications, leading to more positive links with commissioners about future services they will be able to provide on behalf of local populations


LOCALITY: Colne Valley Name: Julie Livesey Interim Locality Manager Tel.no. 01484 345602 Mob.no. 07976 251337

Email address: Julie.Livesey@kirkleespct.nhs.uk

1.

Operational Issues

2.

Partnership Working

Continued monitoring of District Nursing capacity and demand weekly. Currently no winter pressures noted. Long & short term sickness is having a significant impact on teams with continued backfill required from other localities. Health Visiting continues to work on re-configuration issues with 3 teams aiming to combine by end of March, based at Golcar clinic. Commissioning Update: For the two practices in the Colne Valley who are members of the The 3 Valleys Commissioning Consortium, the consortium have identified their key priorities for 07/08 which are Ophthalmology, Diabetes, Cardiology & ENT. These areas will be the main focus for clinical leadership throughout next year, although other service areas will be considered and supported as appropriate. Business cases for service development in Ophthalmology, Diabetes and Cardiology have been submitted to the PCT with a view to shifting demand from secondary care from April 07 onwards (or asap thereafter). Slaithwaite Health Centre is no longer a member of the 3 Valleys Commissioning Consortium due to operational issues in the practice. The 2 practices that are part of Huddersfield central commissioning consortium have taken up the DES for PBC, are participating in Consortium plenary events and are participating in the nursing homes enhanced service. Local Area Committees –presented health action plan. Sexual health training proposals to be considered at Feb meetings of each LAC in the Valleys. Domestic Violence training held in Milnsbridge (Jan) with very positive evaluation. Further training in Slaithwaite in March. Children’s Centres Links for operational staff established and manager linked into Neighbourhood Planning processes. Time out for operational staff held January 2007. Operational staff participating in Neighbourhood Renewal health subgroup for Botham Hall and Trees Public Health Development worker delivering food and nutrition training to Young Mum’s group and also to Youth group for young men in Botham Hall and Trees


3.

QOF update (as required)

4.

Operational Development Plans

5.

Financial issues

The QoF visit has been undertaken at Fieldhead Surgery & reports are pending.

Finance are working towards issuing 2007/8 Practice budgets by 31st March 2007. Locality budgets are showing a deficit.

6.

Anything else, relevant or important


Locality: Children’s Community Nursing Service Name: Ann Brady Children’s Community Matron Tel.no. 01924 351527 Mob.no. 07960 453348

Email address: ann.brady@kirkleespct.nhs.uk

1.

Operational Issues

Service limited to staffing and financial constraints Secondment of 1WTE staff nurse from Supporting Families Team as from 05/02/07 Immunisation team now fully staffed Nurse Specialist-Child Health appointed

2.

Partnership Working

Partnerships with tertiary centres and acute trusts.

3.

QOF update (as required)

Not applicable

4.

Operational Development Plans

Paediatric Dermatology and Paediatric Respiratory Nursing Services to developed and in place by June 2007

5.

Financial issues

No identified budget for Children’s Community Nursing Team or Immunisation Team Under spend identified for the year end

6.

Anything else, relevant or important


Dearne Valley Julie Caddock Locality Manager Tel.no. 01484 345639 Mob.no.

Julie.Caddock@kirkleespct.nhs.uk

1.

Operational Issues

Health Visiting Awaiting restructuring of Health Visitors into corporate team for the Locality. Corporate base likely to be Shepley Health Centre, with satellite bases throughout the locality. The long drawn out delay in implementing the restructuring is proving extremely frustrating for staff , who know changes are going to happen and just want to get on with it! District Nursing Beginning to get on top of capacity issues within the Dearne Valley. Two members of the District Nursing teams have recently returned from long term sickness. Unfortunately our return to full compliment was short lived with another of the full time DN staff going off on, what is likely to be long term sickness absence. Through weekly governance efficiency is beginning to improve, however this involves the locality manager addressing and keeping on top of competency issues.

Community Paramedic Scheme The six month pilot is almost complete. An evaluation is currently being completed, however it remains unclear if the scheme is likely to secure funding to continue despite its successes. Locality Management Meetings These meetings have been on hold for some months now as it was unclear what format the meetings should take to fit in with and compliment the establishment of commissioning consortiums. Locality Cascade Have recently established monthly cascade meetings to disseminate team brief to all staff within the Dearne Locality.


2.

Partnership Working

3.

QOF update (as required)

4.

Operational Development Plans

5.

Financial issues

6.

Anything else, relevant or important


LOCALITY: DEWSBURY LOCALITY Name: Joanne Whincup Locality Manager Tel.no. 01924 351505 Mob.no. 07903752484

Email address: Joanne.whincup@kirkleespct.nhs.uk

1.

Operational Issues

• • • •

2.

Partnership Working

• • • •

3.

QOF update (as required)

N/A

4.

Operational Development Plans

• • •

Out of hours District Nursing team continues to have a large number of vacancies and have experienced significant staff sickness, this pressure is improving as staff are beginning to return to work. District nursing service has vacancies and pressures of sickness are causing problems within one particular team. Health Visiting – 2 members of staff from the locality are seconded to other areas. No significant pressures to report. School Nursing – No significant Issues. Walk In centre – Have appointed a Nurse Practitioner this month and now have a full compliment of staff.

Regular attendance by locality staff at the Dewsbury LAC. Representation at a joint event recently with the local authority looking at the Health priorities of Dewsbury and actions. Continuation of Locality Pilot Implementation Group for the Children’s services Communication has begun regarding integrated teams for District Nursing and Social Services but this is currently difficult due to DN pressures.

The Out Of Hours District Nursing team are working through the Team reconfiguration which was an old night and evening service. Capacity and Demand work is ongoing in the locality with emphasis on systems for monitoring workload and activity Case management in the HV teams is being taken forward along with skill mix and modernisation of the service


5.

Financial issues

• • •

6.

Anything else, relevant or important

Overall the locality has an under spend Budget pressures currently are within the large DN and HV teams as a result of the pay savings. Walk in centre budget is balanced currently


LOCALITY: Holme Valley Name: Julie Livesey Locality Manager Tel.no. 01484 345602 Mob.no. 07976 251337

Email address: Julie.Livesey@kirkleespct.nhs.uk

1.

Operational Issues

Continued monitoring of District Nursing capacity and demand weekly. Currently no winter pressures noted internally. Lack of capacity and changes in local provision of social care services is having a significant effect for DN services. Continuing to await decision to establish one base for Holmfirth DN team. Health Visiting continues to work on re-configuration issues with 3 teams aiming to combine by end of March.

2.

Partnership Working

Commissioning Update: The 3 Valleys Commissioning Consortium have identified their key priorities for 07/08 which are Ophthalmology, Diabetes, Cardiology & ENT. These areas will be the main focus for clinical leadership throughout next year, although other service areas will be considered and supported as appropriate. Business cases for service development in ophthalmology, Diabetes and Cardiology have been submitted to the PCT with a view to shifting demand from secondary care from April 07 onwards (or asap thereafter). The two stand alone practices in Holmfirth are embracing PBC. The Oaklands H/C have been successful in securing funding for a number of service developments. The Elmwood practice are also taking forward service developments, with in-house ophthalmic services and more recently Dermatology out-reach. Local Area Committees – updated public on HVMH land issues + presented health action plan. Sexual health training proposals to be considered at Feb meetings. Domestic Violence training arranged for 28th Feb (Meltham). Children’s Centres Links for operational staff established and manager linked into Neighbourhood Planning processes. Time out with operational staff planned for February 28th 2007.


3.

QOF update (as required)

4.

Operational Development Plans

5.

Financial issues

The QoF visit has been undertaken at Oaklands Health Centre reports are pending.

Finance are working towards issuing 2007/8 Practice budgets by 31st March 2007. Locality budgets are showing a surplus.

6.

Anything else, relevant or important


LOCALITY: Intermediate Care Name: Julia Calcraft Clinical Services Manager Tel.no. 01484 345601 Mob.no. 07766905546

Email address: Julia.calcraft@cht.nhs.uk

1.

Operational Issues

Rapid Response: Vacant OT hours (money in budget) Capacity in admin hours (money in budget) Lack of PCs in office – 2 for 13 staff Maple Ward: 2wte N/A vacancies from mid Feb (vacancy requisition completed for 1) Environment (should be addressed through HVMH project board) DNR transport issues (being addressed through YAS & commissioning)

2.

Partnership Working

Social Services – carers in RR team + dedicated social worker on team Mental Health – CPN seconded into team YAS – direct referrals to team to avoid hospital admission Nursing Homes – Flagship beds Links with community matrons – shared understanding of roes/responsibility

Links with CHT bed flow matrons – understanding of bed pressures – more appropriate referrals GPs – Acute admissions to Maple via ward manager Paramedics – understanding of their pressures, links to DNR transport issues Huddersfield university Greenhead college etc – training, education

3.

QOF update (as required)

N/A

4.

Operational Development Plans

How best to utilize Flagship beds HVMH project board – workstream to move Maple ward to Hawthorn ward

Develop role of Nurse Practitioner 5.

Financial issues

Reduced expenditure by 60k pounds – GPs Therapy staff, staff no longer working on ward, taken off budget, circumspect use of bank staff, & A4C banding appropriately reflected in budget


6.

Anything else, relevant or important

Soap dispensers & soap on ward supplied by CHT who are changing their supplier & want to change all dispensers on ward, with cost implications, is it worth it if ward moving? But if don’t comply unable to get soap!


LOCALITY: Occupational Therapy Rehabilitation and Intermediate Care Services. Name: Pam Lumb Rehabilitation Service Manager Tel.no. 01924 351561 Mob: 07720463019

Email address: pam.lumb@nkpct.nhs.uk

1.

Operational Issues

Development of services at Eddercliffe Centre continues with the transfer of Occupational Therapy Rheumatology Outpatient clinics from Dewsbury District Hospital. Clinics are currently running every two weeks.

Some services are experiencing significant pressures due to a combination of maternity leave, long term sickness and vacancy posts frozen. Staff are working very hard to minimize the impact by trialing alternative ways of working especially in using more clinics instead of home visits.

Intermediates care bed based services have improved occupancy levels in the last month due to staff within the team linking directly with wards in Mid Yorkshire to identify patients who can transfer into our services.

Two services areas have transferred into System One, other service areas are involved with the review of statistical information collected

There is well established partnership working across all areas in Occupational Therapy, Rehabilitation and Intermediate Care Services with many staff working in integrated teams with Social Services and other Health Trusts.

2.

Partnership Working

3.

QOF update (as required)

Not applicable.


4.

Operational Development Plans

5.

Financial issues

6.

Anything else, relevant or important

Community Rehabilitation Team are piloting alternative ways of working using Eddercliffe Centre to provide treatment sessions.

Central point of referral being developed for rehabilitation services based at Eddercliffe Centre.

Domiciliary Physiotherapy services transferred from Mid Yorkshire Trust from 1 January 2007. Work is ongoing to integrate this service.

Service level agreements in place with Mid Yorkshire NHS Trust and South West Yorkshire NHS Trust for Occupational Therapy Services.


LOCALITY: Podiatry Services - North Name: Linda Meeson Service Manager Tel.no. 01924 351539 Mob.no. 07903755625

Email address: linda.meeson@kirkleespct.nhs.uk

1.

Operational Issues

Dealing with temporary relocation of clinical sessions at Cleckheaton due to recent flooding affecting clinical rooms. Reviewing method of statistical collection in preparation for return visit of Meridian – validating new reporting system for SystmOne. Requirement to be compliant with new decontamination regulations from April 2007 – podiatry unlikely to be compliant due to instrumentation issues Staff – 1 maternity leave from end march, 1 retiring early 07, 1 staff member leaving wef 4 2 07.

2.

Partnership Working

Joint working with Diabetes Team from Dewsbury and Wakefield Diabetes network

3.

QOF update (as required)

Not applicable

4.

Operational Development Plans

On-going implementation of DESMOND accredited patient education programme for newly diagnosed type 2 diabetics, development of training programme for practice nurses with regard to foot health screening of low risk patients Utilisation of RS scan plate in biomechanics to improve prescription of orthoses Local project looking at methods of treatment for plantar fasciitis

5.

Financial issues

Service level agreement with Mid Yorks to provide inpatient podiatry treatment for ward patients at Dewsbury

6.

Anything else, relevant or important


LOCALITY: Spenborough Name: Margaret Summers Locality Portfolio Manager Tel.no. 01924 351526 Mob.no. 07904193944

Email address: margaret.summers@nkpct.nhs.uk

1.

Operational Issues

Supporting Families team – no real issues. District Nursing team – 2 WTE band 5’s on maternity leave, and a further 0.66 WTE band 5 due to finish this month, 1 WTE band 5 on long term sick leave and a 0.80 WTE band 4 HCA off following a bereavement. A WTE band 6 nurse moved over on a temporary basis to help ease the pressure in Huddersfield. This has resulted in reorganising the DN team in order to work as effectively as possible during this time.

2.

Partnership Working

Supporting families team continues to work in partnership with education and the children’s centres.

3.

QOF update (as required)

Not applicable.

4.

Operational Development Plans

The District Nursing messaging service run through SSIP has now been established in the Spenborough locality

5.

Financial issues

The overall budget at present is on balance.

6.

Anything else, relevant or important


LOCALITY: Spenborough (Northern Kirklees Admin Support & Premises Name: Nigel Grimshaw Locality Portfolio Manager Tel.no. 01924 351526 Mob.no. 07903407417

Email address: Nigel.grimshaw@kirkleespct.nhs.uk

1.

Operational Issues

Have redeployed staff to provide support to other teams and to cover other priorities. Effect on service delivery to be monitored. Child Health have successfully gone live on SystmOne clinical computer system and we are monitoring and managing the issues that have arisen to date.

2.

Partnership Working

Working with Bradford Council on a pilot project to improve the customer service skills of frontline admin teams.

3.

QOF update (as required)

Not applicable.

4.

Operational Development Plans

Work continues to improve customer service skills for admin teams

5.

Financial issues

Child Health Services is a cost pressure due to one-off costs of reconfiguring the service during 2006 and other cost pressures identified in the business plan for 2005/06

6.

Anything else, relevant or important

Flooding at Cleckheaton Health Centre has left many clinic rooms unavailable, which is affecting smooth delivery of services (although this is being managed successfully). No timescales for repair/renovation yet provided.


LOCALITY: Speech& Language Therapy – North Name: June Sennett SLT secretary Tel.no. 01924 351546

Email address: june.sennett@kirkleespct.nhs.uk

1.

Operational Issues

• •

2.

Partnership Working

• •

Reviewing our method of recording statistical information in preparation for return visit of Meridian. In April we will carry 0:5 WTE vacancy for a specialist SLT working within Learning Disabilities.

Joint working with Wakefield SLT service to standardise training around stroke patients. Close liaison with Mid Yorkshire Trust, SWYMHT, Local Authority and Education services.

3.

QOF update (as required)

Not applicable.

4.

Operational Development Plans

Development of an SLT service website. Currently awaiting for the information to be inputted on the system

5.

Financial issues

• •

Awaiting monies from Education Services. Service level agreements in place with Mid Yorkshire Trust and SWYMHT.

6.

Anything else, relevant or important

http://www.kirklees.nhs.uk/fileadmin/documents/meetings/February_07/KPCT-07-20%20Locality%20Board%20  

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