Agenda item

NORTH EAST MANCHESTER DIABETIC EYE SCREENING REVIEW AND ENGAGEMENT PROCESS

In attendance will be Jane Pilkington; Head of Public Health Commissioning (Greater Manchester); Dr Graham Wardman – Consultant in Screening and Immunisation; Audrey Howarth – Screening and Immunisation Manager; Ruth Molloy – Screening and Immunisation Coordinator.

 

Reports attached.

 

Minutes:

The following officers attended the meetingto provide members of the committee with a verbal presentation in respect to the proposed changes to the north east sector diabetic eye screening programme and provide details of the communications and engagement plan:

 

Dr Graham Wardman: Consultant in Screening and Immunisation; Audrey Howarth: Screening and Immunisation Manager; Jane Pilkington: Head of Public Health Commissioning NHS England; Mr T Hashmi: Clinical Lead Diabetic Eye Screening Programme; Tanveer Kausser: Programme manager – Diabetic Eye Screening Programme;Amanda Stocks: Communications Hub Team Manager; Hilda Yarker Strategic Consultant for Patient and Public Engagement NHS England.

 

The presentation contained the following information:

 

The aim of the National Diabetic Eye Screening Programme (DESP) is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight threatening diabetic retinopathy, at the appropriate stage during the disease process.

 

Since 2008 this has been delivered using a community based mobile service, operating by the movement of digital cameras from 16-17 clinic sites across the Boroughs of Bury, Oldham and Rochdale. 

 

Following an External Quality Assurance visit in 2012, several recommendations made reference to the quality and safety of the way the service was being delivered; in particular the review highlighted

·         the unsafe nature of transfer of data by USB sticks

·         concerns regarding the frequent movement/transportation of digital camera’s.

·         Identification of availability of sites had to be negotiated annually, prime site occupancy for certain sites was affected by short term booking.

·         The quality and safety of the programme was being compromised by the lack of an N3 connection. The N3 network is designed to ensure confidentiality and a safe way to transfer digital photographs and other information by NHS users.

·         The operational model of camera transfer between sites had set up implications for both the digital cameras and staff; digital camera downtime was significant – up to one day lost in the transit, staff time was lost due to the necessity to use two staff for the transfer.

 

Following a Serious Incident in the North east sector in February 2014, Diabetic eye screening sites were reduced from 16-17 to 6 as an interim measure to ensure the safety of the screening programme. It was intended to perform a full review of the screening sites for the programme within 6 months of the implementation of the 6 interim static sites. Work began on this review at the beginning of 2015 and a Communication and Engagement sub-group was established in April to support this process.

 

A Communication and Engagement plan has been produced by this group to ensure that a comprehensive and meaningful engagement exercise can take place to influence the outcomes of the review, alongside the other clinical, equality impact work being undertaken by the programme.  The engagement will be undertaken by the Commissioner, NHS England and Provider, Pennine Acute NHS Trust.

 

Those present were given the opportunity to ask questions and make comments and the following points were raised:

 

In response to a Member’s question Dr.Wardman reported that the proposed changes are not as a result of having to make financial savings, the resources will remain the same.  Included as part of the change, is a proposal to expand the hours and accessibility of the service, as well as an aim to improve the uptake of the service.  The current uptake of the service is 76%, the highest percentage of non-attendees is from the working age population and it is hoped by reconfiguring the service the uptake will increase.

 

Dr. Wardman reported that the following the serious untoward incident and the necessity to introduce interim measures, NHS England acknowledge that they did not communicate with service users as well as they would have liked; lessons have been learnt and this learning has informed the subsequent pre-engagement and engagement phase.

 

The Clinical Lead Diabetic Eye Screening Programme reported that the proposed changes to the service will result in the image being transferred immediately via a safe secure N3 connection this will prevent as has happened in the past, a backlog of images waiting to be processed.

 

In response to a Member’s question, the Programme manager – Diabetic Eye Screening Programme reported that there had been a historical lack of forward planning when booking clinic sites.  The criteria for screening sites now included planned bookings, accessibility and provision of a safe N3 connection.

 

Members sought clarification in relation to the serious untoward incident.  The Clinical Lead reported that data sticks were previously used to hold images, the data sticks were corrupted, this resulted in a delay in the images being reviewed.  The Clinical Lead reported that no one was harmed as a result of the delay, all images were reviewed. There was however a slight delay in some of the images being reviewed as a result of which there was a requirement to record the incident as a serious untoward incident and patients informed

 

In response to a Member’s question in relation to how the decision was made to select the sites in the period following the incident; the Programme Manager reported that the service reviewed who were in immediate need of the service, where had recently been screened, the easy availability of an N3 connection.  The Programme Manager reported that the service could have communicated better with residents of Heywood in respect of the changes to the location of the screening facility.

 

The Screening and Immunisation Manager reported that the work is ongoing to raise the profile of the screening programme, members of her team work with GPs, support groups and practicenurses to encourage patients to attend their screening appointments.

 

The Head of Public Health Commissioning NHS England reported that this screening programme is very effective and delivering real health outcomes. Studies now show that since the commencement of Diabetic Eye screening in 2007, and for the first time in 50 years Diabetic Retinopathy is no longer the leading cause of blindness in adults. This is even more impressive given the significant increase over the past decade in diabetes.  She reiterated that the proposed changes are not a result of a need to reduce budgets but rather a set of proposals to see how current investment can deliver the best health outcomes and will result in a more equitable and fair service.

 

The Chair reported that he would take questions from members of the public present at the meeting.

 

 

Members of the Committee were given a further opportunity to ask questions of the officers present at the meeting and the following issues were raised:

 

In response to concerns raised by the Chair; Dr.Wardman reported that they would ensure that the proposals did not disadvantage service users in any of the three Boroughs and will pay particular attention to any potential transport issues.

 

In respect of the site in Saddleworth, there were problems with the previous venue a different venue is to be considered as part of the review process.

 

Dr Wardman reported that NHS England is in contact with Arriva/TfGM in respect of the proposed changes.

 

The inclusion of potential sites in Croft Shifa is to allow ease of access to residents living in the area surrounding Littleborough.

 

In response to concerns raised with regards to the proposal to hold the engagement events in August, the Strategic Consultant for Patient and Public Engagement reported that a large amount of work has been undertaken in the pre-engagement stage.  Further work will be undertaken at the commencement of the engagement, this will include three public events in Middleton, Oldham and Bury; an anonymised staff questionnaire, information in appointment letters and engaging with those attending clinic during the engagement period.

 

It was agreed:

 

1.   Members of the Joint Committee were agreed that patients, the public and staff were engaged throughout the development of the proposals.

2.   An additional public event will be held in Rochdale during the four week engagement period.

3.   The Joint Committee are satisfied with the proposals and agree to the start of a 4 week period of formal public engagement from Monday, 3 August to Sunday, 30 August 2015.

4.   Following the conclusion of the engagement a reporting detailing the findings will be circulated to members of the Joint Health Overview and Scrutiny Committee.

 

 

 

 

 

Supporting documents: