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Minutes of the Patients Forum held on July 13th 2005 at Friends House, Euston Road, London NW1  

MINUTES OF THE PATIENTS FORUM MEETING HELD ON 13TH JULY, 2005 AT FRIENDS HOUSE, LONDON NW1

 Present:  Jonathan Ellis (Chair) – Help the Aged:  Brian McGinnis (L’Arche); Mike Took (Rethink);  Eileen Neilson (RPSGB);  Carol Herrity (Royal Mencap); Geraldine Amos (Home from Hospital Care);  Sara Apps (Which?);  Gerda Loosemore-Reppen (Sign)

 Apologies: Hew Helps (Chiropractic Patients Association); Samantha Sharp (Alzheimer’s Society);  Carole Myer) Royal College of Paediatrics and Child Health); Edith Todd (NAPP);  Philip Hurst (Age Concern England ); Toby Williamson (Mental Health Federation)  

Dental Complaints within the Private Sector -  Gordon Miles – Director, Private Patient Complaints, General Dental Council

The Role of the National Clinical Assessment Services (NCAS) in relation to dentistry

Dr. Janine Brooks – Associate Director (Dentistry) NCAS  

(See appendix for Powerpoint presentations)

Minutes of last meeting held on 12th May 2005

The minutes were agreed.  There were no matters arising  

Minutes of the Management Committee held on  12th May 2005  

No comments  

Chair’s Report

 The 2005 AGM would be held on 26^th September (deferred from 1^st September) as Harry Cayton would not now be able to attend the earlier date.  It was one of the functions of the AGM to elect new members of the Management Committee.  If people were interested in taking part or getting involved in the Committee, they were invited to get in touch with the Chair.

 The Management Committee would be holding an Awayday/Strategy day in September.  It had originally been planned for the 8^th of July but events had prevented this.  The purpose of it would be to consider where the Patients Forum went next and what it should be doing, including project work and activities to drive the Forum forward.  There would be an outcome from that meeting that would be shared with people at the AGM with an opportunity to provide feedback before a concrete plan of action was agreed on. 

 Information Exchange     

Brian McGinnis (L’Arche).  It was reported that a number of the Royal Colleges were having open days as part of public liaison.  The Royal College of Physicians was the previous Saturday, the Royal College of Psychiatrists would be the following day. The Royal College of Physicians one had been really good. A lot of the participants were medical students because they were focusing on helping people understand what doctors did, but there were a number of members of the public who had drifted in on their way to the zoo and there was a really good communication going, picking up where medicine has got to and where physicians were at.    It was also reported that while it might be thought that who carried health responsibility for somebody was pretty clear cut, this was not in fact the case. The Tizard Centre at the University of Kent had just done a piece of work on Health and Social Services responsibility for people who were not living where they had started their lives. In other words, they had been placed in a residential home or whatever, somewhere else. Kent probably had about 2000 people who had been exported by London boroughs or other places to Kent , mainly because they did not have decent local services.  On the whole, general practice responsibility rested with the GP nearest to where the person was.    There was still an issue about whether that GP could charge extra for looking after someone in a residential home, and that was not entirely clear-cut.  On the whole, the local GP carried primary care responsibility .    Healthcare responsibility was extremely complicated.   A person might still come under the overall healthcare responsibility of the authority that exported them.   They might come under the healthcare responsibility of the area in which they were now residing.  It might be unclear as to who carried healthcare responsibility.    Where there was GP responsibility for primary care but distant health authority for secondary care, getting liaison was even more difficult than it was in other circumstances.  This was felt to be an odd corner of the NHS where there was still no clarity as to those responsible for healthcare and these were quite often people who had slightly above the average of healthcare needs.

Mike Took (Rethink).  It was reported that the Mental Capacity Act got Royal Assent shortly before the General Election and it would be implemented from 1^st April 2007.   It had taken 16 years to get the stage of Royal Assent.  The mental health legislation reform had started in 1998, so fairly recently, and had that day reached the stage of the Department of Health producing its response to the pre-parliamentary scrutiny.   It was felt that it would have a rough passage through Parliament because the Conservatives and the Liberal Democrats were flatly opposed to it and a certain number of Labour MPs would vote against anything produced by a New Labour government.   

 Angeline Burke (NMC).  It was reported that a new leaflet had been produced about the NMC and what it did and copies were circulated.   They had also produced leaflets on how to complain about a nurse or midwife with one for each country, apart from Scotland .  The Welsh one was available in English and Welsh.  

It was also reported that several consultations were taking place.  The first related to specialist community public health nurses, formerly known as health visitors.  They were on the third part of the new NMC register.   To be on the third part of the register, the person  was also required to be on one of the other parts, either nursing or midwifery.   They were asking this category, when it came to reregistration at the end of each three year period, to register on two parts of the register or just the one part.

 The second consultation, on the NMC website, was about overseas trained midwives and how they registered themselves in the UK .   One of the pertinent factors here was whether all overseas trained midwives, other than EU trained, should take a language test.   It was felt this would be quite controversial.  This also had implications for nursing as well because if the NMC decided to go down the route that all overseas trained midwives should take a language test and attain a certain standard then this would have to be implemented for nurses as well.  The consultation was proposing that the level of attainment of the international language test be raised.     

There was a request that where organisations were holding conferences and felt it would be useful for NMC to attend or to have a stall could they contact Angeline. NMC were currently planning their future programme and wanted to get members of the public and user groups involved with their work and this was a way of doing that.  

 Finally, NMC was in the early stages of looking at the absolute minimum expectations of nurses.  There was a request to send examples of both good and bad practice to Angeline.   A booklet would be produced setting out the expectations of nurses and midwives.

Eileen Neilsen (Royal Pharmaceutical Society GB).  It was reported that they had a newly constituted Council of one-third lay members, the other twenty being pharmacists.  They were now participating in the Foster Review – a review of non-medical regulation – that was running in parallel with the Chief Medical Officer’s review of the GMC.  This last had come out of the fifth Shipman Report with its recommendations about the future of the GMC.   Eileen reported that she was now PPI lead for the Society with two strands of work:  one to create a PPI strategy for the Society that would mix PPI into all its major functions.   They were now in the process of appointing a contractor to take that work on.  It was due to start in September.  It was anticipated that this process would take until May 2007 to have something up and running that could be identified as changing the way the Society worked.    Finally, it was reported that the Health Regulators had set up a PPI group and Eileen was the Society’s representative on that group.    It has a whole programme of work going forward that could be of interest to members of the Patients Forum .

Sara Apps (Which?).  It was reported that they were awaiting publication of their “Choice” report. This had come out of the conference they had held earlier this year.     Their main focus at the moment was preparing for the White Paper – Healthcare Outside Hospitals – and they were trying to glean as much information as they could about what would be in the Paper.   What was known was that ‘extending contestability’ was likely to be in it and there were a number of areas of concern around that:  complaints and redress and voice and choice.   They were also looking at out-of-hours work and were still awaiting the Government’s response to the Health Select Committee Medicine Regulation Enquiry and Recommendations.  

Gerda Loosemore-Reppen (Sign).    It was reported that the major item of interest was the implementation of the Government guidelines on mental health services for deaf people:  Towards Equity in Access.   The Government had finally set up an implementation group under the auspices of the British Society for Mental Health and Deafness, a voluntary organisation. Various representatives of deaf organisations and the NHS were supposed to be members of that group.    Sign had seconded, at its own expense, a number of staff to follow up the implementation of these guidelines in order to see that PCTs were actually implementing the twenty six recommendations in the guidelines document.  The major challenge would be to identify who in a PCT would be responsible and where the money that had been allocated was spent and on what.  

It was also reported that the software developed by Sign to enable GPs to communicate with deaf users in the absence of interpreters was now available.  PCTs had been informed that they could license the software but to-date none of them had wanted to do this.  Sign would be going back to the Department of Health, which had appeared to be very interested in this new communication tool -  one of the recommendations in the Guidelines - namely that PCTs should access software. Sign would ask the Department’s help to disseminate the information and encourage PCTs to license the software.  This would be very cheap.    

Finally, it was reported that Sign was also likely to be very interested in the measurement of quality in GP surgeries, the quality performance framework.  Looking at it in greater detail it seemed that none of the disabled issues that had been discussed earlier in relation to dentists were reflected in the document.  The patient experience received very few brownie points and the measurement of GP performance and disabled access did not feature at all.  The question arising from this was could anything be done about it in the longer term in co-operation with like-minded patient organisations to bring pressure on that powers that be. 

Jonathan Ellis (Help the Aged).   A couple of short items were reported.  First, they had responded to the recent NICE consultation on Social Value Judgements which seemed to imply, bizarrely that discrimination on the basis of  gender, ethnicity or any other factor was unjustifiable but that age discrimination could be justifiable.   It was felt that this was a strange conclusion for an NHS body to reach and they had been piling on the pressure about this and were waiting for the NICE Board to make its final determination on whether they would accept that proposal.  Secondly, there was a huge amount of work arising from the Green Paper on Adult Social Care.  The consultation on this would close in a couple of weeks.    They were frantically drafting and redrafting at the moment.    They were also waiting for the Government’s response to the Health Select Committee Enquiry into Continuing Care published just before the election.  This would look at issues around when the NHS was solely responsible for meeting a person’s long-term care needs and when the responsibility should be shared with local authorities and, indeed, with the individual.  Finally, since the last Patients Forum general meeting in May, they had published two reports on older people’s experiences of death and dying.  One was a major piece of research looking at the knowledge base, the elements base and what we knew around palliative care access to services.  The second reported looked at this issue much more from older people’s perspectives of what it was they worried about and what support they would want to have as they approached the end of their lives.   That would be a major programme of work over the following twelve months.   

 Appendix 

Speaker:  Gordon Miles - Director, Private Patient Complaints, General Dental Council

               Dental complaints within the private sector          (Powerpoint1)

Speaker: Dr Janine Brooks, Associate Director (Dentistry), National Clinical Assessment Services (NCAS)

              The role of the National Clinical Assessment Services (NCAS) in relation to dentistry (Powerpoint 2)

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