Agenda and minutes

At this point in the meeting, Members are asked to declare any personal, prejudicial or disclosable pecuniary interests they may have in the business on this agenda.

Members were invited to declare at this point in the meeting any personal, prejudicial or disclosable pecuniary interests, other than those listed on the standing declarations attached to the agenda, that they might have had.

Councillor Cuthbertson declared a personal interest in the business on the agenda as an ongoing patient at York Hospital.

Councillor Fraser declared a personal interest in the business on the agenda as a Council appointee to the York Hospital Board of Governors. He also declared a personal interest in the general remit of the Committee as a retired member of UNISON and Unite (TGWU/ACTS sections).

Councillor Hodgson declared personal interests in the general remit of the Committee as a member of the York Co-operative Party and UNISON.

Councillor Wiseman declared personal interests in the business on the agenda as a Public Governor of York Teaching Hospital NHS Foundation Trust and as a member of the Shadow Health and Wellbeing Board.

No other interests were declared.

At this point in the meeting, members of the public who have registered their wish to speak regarding an item on the agenda or an issue within the Committee’s remit can do so. The deadline for registering is Friday 3 August 2012 at 5:00 pm.

It was reported that there had been one registration to speak under the Council’s Public Participation Scheme.

George Wood from York Older People’s Assembly spoke regarding item Agenda Item 3 (Interim Report-End of Life Care Review ‘The Use and Effectiveness of DNACPR (Do Not Attempt Cardio Pulmonary Resuscitation) Forms’). He highlighted to Members that patients and close relatives would be at their most vulnerable if they were in a situation when they had to decide whether or not to allow for CPR to be performed.

In reference to the NHS leaflet at Annex G to the report (“What happens if my heart stops?”) which was attached at Annex G to the agenda, he felt that the publicity and availability of the leaflet had a high value in that it could prompt discussions between patients and GPs around a very sensitive subject.

This report updates the Committee on progress made in relation to their review on End of Life Care. It also asks them to discuss further some of the issues raised to date and to identify the next steps for the review.

Members considered a report which updated them on progress that had been made in relation to their review on End of Life Care. It also asked them to discuss further some of the issues raised to date and to identify the next steps in the review.

The Clinical Director of Unscheduled Care and the Director of Partnerships and Innovation from Harrogate and District Foundation Trust (who had the contract to run the York and Selby Out of Hours Service) presented papers to the Committee, which were attached at Annexes H-H4 to the report.

In addition to the information contained within their report they highlighted the following key points:

·        There were concerns about some of the anecdotal evidence that had previously been received as part of this review and the Out of Hours Service were concerned that these comments were taken in context of how their service operated. The Out of Hours Service saw approximately 130, 000 patients a year and provided a range of different services. Much of the time everything ran very smoothly, however when dealing with this many patients then occasionally the service would not get everything right

·        Decisions to put a DNACPR order in place lies with the ‘in hours’ service i.e. with the patient’s GP or with the hospital.

·        The Out of Hours Service does not have a role in putting DNACPR orders in place as they have little prior knowledge of the patient – it would therefore be deemed inappropriate.

·        This was a multi-step process and unfortunately there were some problems with the various different IT systems and how they communicated with each other.

·        Varying degrees of access to patients records between hospital, GPs and  Out of Hours Service.

·        The call handling service for the Out of Hours Service is operated by Yorkshire Ambulance Service; when a patient or their carer/relative phones in distress this can trigger an ambulance response.

·        DNACPR does not mean ‘do not treat’ – we have to be clear what we are discussing here – admitting a patient to hospital, even if there is a DNACPR in place, is not always the wrong thing to do.

·        Since the provider arm of the Primary Care Trust (PCT) was split the Out of Hours (OOH) service was operated by Harrogate and District Foundation Trust and the District Nurses by York Teaching Hospital NHS Foundation Trust – the two organisations had slightly different agendas and the two were slightly less joined up than when one organisation had responsibility for both.

·        Challenges for the OOH with decreasing budget over the past five years but an increase in activity.

·        Concerns about what impact the NHS 111 Service will have on OOH – this could increase OOH workload but with no extra resources available.

·        If looking for ways of improving – there was a need for a better flow of interagency communication.

Members asked questions around access to medical records, ongoing projects within IT and where the NHS was at with improving continuity and information sharing. In  ...  view the full minutes text for item 21.