Joint Working

Health and Social Services Councils joined forces to undertake a number of projects. The following gives a flavour of what members and staff have been involved in.

Advocacy Project

The question is often asked ‘what is advocacy?’ The dictionary defines it as ‘one who argues or defends the cause of another, a supporter, to plead in favour of.’

This project followed on from a super complaint made by WHICH to the Office of Fair Trading about the lack of advocacy for older persons in residential/nursing homes. Consequent findings from the Office of Fair Trading Market Study made a number of recommendations to the Department of Health. A Project Steering Group was set up and Councils, in association with the Regulation and Quality Improvement Authority who monitor and inspect the availability and quality of Health and Social Care, undertook to audit current advocacy arrangements within nursing and residential care in homes in Northern Ireland.

Meetings took place with stakeholders, a questionnaire was distributed to each home providing services for older persons and a number of relatives’ focus groups and residents’ interviews were arranged.

Findings:-

Stakeholders:

	It was suggested that an independent element to advocacy services was important but that this required close partnership with service providers
	The importance of training and supporting residents to speak for themselves was highlighted

Homes:

	80% of care homes that responded stated that they provided advocacy services with 17% providing advocacy training, usually as part of staff induction
	Information was provided through Home staff, the patient and resident guide and via residents’ and relatives’ meetings

Relatives’ Focus Groups:

A number of practical ways to promote advocacy were suggested such as establishing relatives groups, monthly advocacy clinics in the Home and printed information packs

Residents’ Interviews:

	The advocacy support received from staff and relatives was valued
	Ways in which they received advocacy were identified eg. through a keyworker, information and meetings
	It was felt that advocacy could help them in choosing the right home, getting increased satisfaction and being more independent.

Those involved in all aspects of service delivery, planning and regulation of residential services for older people will be invited to a Seminar to hear at first hand the results of the audit and to add their experience to the audit findings. Recommendations from the seminar will be incorporated into a final report to be launched in the autumn.

Members of the Project Steering Group

Rural Medicine

In recognition of the difficulties in providing hospital services to all rural communities, the then Health Minister asked the Chief Medical Officer to review how general medicine can best be provided to all rural communities in Northern Ireland to achieve an appropriate balance between accessibility and safe, high quality practice.

April 2006 saw the Department of Health, Social Services and Public Safety establish a Rural Medicines Working Group, its membership drawn from across the health care professions, including representatives from primary, secondary and community care together with the Health and Social Services Councils.

The Group had the specific remit of developing quality standards for inpatient medical services in rural and local hospital settings.

The key issues the group considered included:

	Quality and safety
	The needs of the rural population to access high quality and safe services
	How primary and community care could support patient access and management
	How to ensure effective responses to manage emergencies

The four Councils in association with the Department of Health, Social Services and Public Safety then facilitated a workshop to provide service users with the opportunity to contribute to the policy making process by sharing their own experiences and ideas on the provision of general inpatient medical services in rural and local hospitals.

User Involvement

A four Council initiative aimed to develop standards and indicators for user participation. Based on research undertaken by the Southern Health and Social Services Council the work will influence current work and guide the future role of the Patient and Client Council. Councils were also involved in a number of user involvement initiatives in partnership with the Department of Health, Social Services and Public Safety.

‘Establishing Principles of User Participation’ was the theme of a joint Council event held in October 2006. This was held as it was felt there was a need:

	to move away from the Health and Social Services Councils being viewed as ‘proxy patients’
	to develop best practice for Council engagement with service users
	to influence the existing and proposed commissioners and providers
	to influence the Patient and Client Council’s work and promote its role as commentator on standards of user participation and best practice

The standards developed will be used to inform/influence the Department of Health, Social Services and Public Safety User Involvement Strategy and to inform Councils when supporting the Department in its consultation on the Rural Medicine Strategy.