1 Summary

1.1 This report aims to seek approval from the Executive Member for the use of Clinical Governance Strategy to support clinical staff working in Hampshire County Councils new nursing homes. This report provides information on why there is a need for a Clinical Governance Strategy. The report will also outline the strategy and give information on how it will be implemented to improve services for older people.

1.2 The decisions sought support Corporate Strategy Aim 5 - Improving Services by aiming to achieve consistently high levels of customer satisfaction across all services and Aim 6 Developing Councillors and staff by using Clinical Governance to ensure the continuous professional development of clinical staff employed by Hampshire County Council.

2 Objective

2.1 The aim of this report is to seek the approval of the Social Care Executive Member for the use of the Clinical Governance Strategy to support clinical staff and help to improve services for older people.

3 Contextual Information

3.1 The Nursing Care Investment Strategy will provide ten Social Services led Nursing Units across Hampshire. Seven of these units will be alongside existing Older Persons' Residential Care units and three will be `stand-alone' units built on National Health Service land. This will provide a total of 500 Nursing Care beds for Older Persons.

3.2 A total of 487 full-time equivalent staff will be employed to work within these units. For the first time Social Services will be employing Registered Nurses in a nursing role. Hampshire County Council will employ the nursing workforce within the Section 31 agreement of the 1999 Health Act.

3.3 Clinical Governance was introduced to organisations providing clinical care in 1998 by the Department of Health `The New NHS' document. It is designed to introduce a systematic approach to the delivery of high quality health care.

4 Purpose of Clinical Governance

4.1 The most widely used definition of Clinical Governance is:

"A framework through which organisations are accountable for continuously improving the quality of their services and safe-guarding high standards of care by creating an environment in which excellence in clinical care will flourish".

4.2 The core values of clinical governance are:

(i) The service users' experience is the central focus, which includes involving them in making decisions about their care and keeping them informed

(ii) A commitment to quality, which makes certain that professionals are up to date in their practice, are expertly supervised and develop an environment where learning is built into every day practice

(iii) Continuous improvement of services and care

(iv) A reduction of risk from clinical errors, adverse events and near misses, as well as a commitment to learn from mistakes and share that learning with others

4.3 Hampshire County Councils' Clinical Governance Strategy will ensure that the quality of care delivered is of a high standard and is centred on meeting the needs of individual residents in the councils' nursing homes.

4.4 Each component of the strategy covers an aspect that will have direct or indirect impact on the delivery of clinical care to residents.

The components centre on improving the residents' experience of care by involving them and their carers in planning care, by continuously developing staff with training and education, by carrying out clinical audit and clinical effectiveness programmes, by ensuring the residents' Health and Safety with Risk Management and by developing clinical policies and procedures to support staff with delivery of care.

4.5 A practice manual for staff has been written to cover all aspects of procedures and policies within the nursing and care homes. This covers an update of existing procedures and new ones for clinical matters.

4.6 In writing this report and developing the strategy regard has been given to the County Councils' duties in relation to the Race Relations Amendment Act 2000 and Hampshire County Councils' own race equality scheme.

5 Accountability and Reporting

5.1 The Director of Social Services is ultimately accountable for the quality of clinical care. The progress and development of all Clinical Governance components will be monitored and reported through the Clinical Governance and Risk Management Group (CGRMG). Reports will be circulated annually.

5.2 The Clinical Governance and Risk Management Group membership will include a lead officer for training, human resources, risk management, performance management (operational), nurse advisor, nurse managers and the Director of Residential and Nursing Care. National Health Service representatives will also be invited.

6 Costs

6.1 The implementation costs for Clinical Governance will be two-fold.

6.2 Staff time for Clinical Governance Steering Group, report writing, investigation and ensuring implementation of recommendations especially following adverse incidents.

6.3 Training and development of staff. This is included in the current training and development budget for the Nursing Care investment strategy.

RECOMMENDATIONS

1. That the core values be approved as the basis for the Clinical Governance Strategy being developed.

Section 100 D - Local Government Act 1972 - Background Documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act

NONE