LEICESTERSHIRE PARTNERSHIP NHS TRUST, SERVICE LEVEL AGREEMENT, FINAL REPORT

Following extended discussion and a number of meetings, a Service Level Agreement (SLA) between Leicester City PCT and Leicester Council of Faiths was signed on 31 March 2009. This contract ended formally on 31 May 2012. Here's an amended version of the final report on this agreement, that I submitted today. All these topics are covered extensively throughout this blog.

We were originally contracted to work with Leicester City PCT but got caught up in redeployment issues within the NHS locally, both of staff and of responsibilities. Management of our contract was put into the hands of the Integrated Equalities Team at Leicestershire Partnership NHS Trust. Consequently (and through no fault of our own) it took longer than we would have liked for actual work to take place in furthering the aims of our SLA.

NHS Staff Multifaith Resource

Following a year and more of consultation among the eight member communites of Leicester Council of Faiths and a variety of other communities of religion or belief (Humanist, Jehovah’s Witnesses, Mormon, Pagan, Rastafarian, Spiritualist), Leicestershire Partnership NHS Trust published a Staff Multifaith Resource. This pack provides the following information in the same order, for each of the communities of religion or belief included:

• Introduction and local information
• Mode of greeting
• Birth
• Examination of patient
• Particular sensitivities
• Washing, ablutions and personal hygiene
• Modesty and dress
• Special dietary requirements
• Fasting
• Family planning
• Abortion
• Care in serious (or final stages of) illness
• Blood transfusion / transplants
• Organ donation
• Spiritual advisor / counsellor
• Death
• Religious symbols
• Post mortem
• Burial / cremation
• General considerations for community nurses visiting patients at home

The Multifaith Staff Resource was officially launched during Inter Faith Week 2011 with three lunchtime meetings on consecutive days in the Brandon Unit, Glenfield Hospital. (Tue 22 Nov), Mansion House, Glenfield Hospital (Wed 23 Nov) and at Leicester General (Thu 24 Nov).

Shortly before the end of 2011, a programme of induction began for ward staff in the city, county and Rutland and for Community Teams in the same areas and for the Trust’s Spiritual and Pastoral Care Team. This induction programme was delivered alongside Abida Hussain, the Trust’s Equalities and Human Rights Officer.

Faith Community Health Ambassadors

The idea for this project originated in a full meeting of Leicester Council of Faiths at the Welcome Centre (13 July 2010), on the topic of health inequalities. This meeting was addressed by Deb Watson (Director of Public Health, Leicester City PCT) and her Assistant Director, Rod Moore.  Deb also presented a refined version of this proposal at the Council of Faiths AGM (21 Oct 2010). Since this programme kicked into action, around 30 short video interviews have been conducted with individuals from a variety of backgrounds of religion or belief for use in training of staff with Leicestershire Partnership NHS Trust. In these videos, subjects answer questions about how their religion or belief impact on their health and how they access healthcare services. Contributors identified with a particular religion or belief as follows: 

• 2 Baha’is
• 5 Buddhists
• 4 Christians
• 7 Hindus
• 1 Humanist
• 2 Jews
• 6 Muslims
• 1 Rastafarian
• 1 Secularist
• 3 Sikhs

Equality Delivery System

We were invited to take part in community consultation on LPT’s equality objectives at two meetings: 10 March 2011 at the Towers and (with an extended group of stakeholders)  8 March 2011 at Mansion House, Glenfield Hospital.

These meetings led to progress on the development of LPT’s Equality Delivery System (EDS). I was asked to participate in a meeting with a variety of stakeholders to grade LPT’s Equality Delivery System at the Peepul Centre, Orchardson Avenue, Monday 27 February 2012.

The same individuals who were recorded for the Faith Community Health Ambassadors project were contacted and asked to take part in a community engagement review of LPT’s Equality Delivery System in a meeting at Merlyn Vaz Health & Social Care Centre, Spinney Hill Road on Wednesday 28 November. Although only two people turned up in person, several other responses were received by post.

Impact attendant on proposed closure of children’s heart unit at Glenfield Hospital

I was asked to coordinate the Council of Faiths’ response to impacts attendant on the possible closure of the children’s heart unit at Glenfield Hospital. Following a one-to-one briefing with Christina Marriott, ?? at LPT HQ, Lakeside, Grove Park, Monday 28 May 2012, members were canvassed for their responses, then a three page-long response was submitted, 30 May 2012. 

BISHOP IS BACKING HEART UNIT CAMPAIGN

This article appears in today's Leicester Mercury:

Bishop is backing heart unit campaign

The Bishop of Leicester has criticised plans to move children's heart surgery and the specialist extra corporeal membrane oxygenation (Ecmo) treatment from Glenfield Hospital.

The Rt Rev Tim Stevens signed an online petition calling on Health Secretary Andrew Lansley to re-think plans to move the services to Birmingham.

Glenfield Hospital is one of four centres in England that will cease to provide surgery for children born with heart problems, following an NHS review.

Bishop Tim said: "In recent days, I have received a large number of letters and e-mails and had conversations with numerous people who are concerned that the loss of the children's heart surgery unit and the Ecmo facility from Leicester will significantly harm the chances of people living in the East Midlands and further afield in the eastern part of the UK.

"I have visited the heart surgery unit and know that it and the Ecmo facility have an international reputation for excellence.

"Skill levels and success rates are higher than similar services elsewhere.

"It is not at all clear the move to Birmingham will be straightforward."In fact, I fear the movement of these services will be harmful to the nation as a whole, as the skills of a unique team will potentially be lost.

"It has been reported that it may take anywhere between five and 20 years to recover the Ecmo skills currently at Glenfield."

Bishop Tim said he would be raising the matter in the House of Lords when it resumes sitting.

The online petition has now been signed by more than 57,500 people since it was set up at the start of July.

To sign the petition go to: http://epetitions.direct.gov.uk/

IMPACT OF CLOSURE OF CHILDREN'S CONGENITAL HEART UNIT, GLENFIELD HOSPITAL

This afternoon I’m at the headquarters of Leicestershire Partnership NHS Trust. I’ve been asked to attend a briefing with Christina Marriott, Manager of the Integrated Equalities Unit at Leicestershire Partnership NHS Trust, on potential impacts of the closure of the Children's Congenital Heart Unit at Glenfield Hospital. No such decision has been made yet and consultations on the impacts of closure have to be discussed before the decision can be taken.

Christian is having meetings with representatives from organisations standing for each of the relevant Protected Characteristics as defined in the Equality Act 2010, asking for their responses and collating their contributions.

This consultation is not on the subject of whether or not the Children's Congenital Heart Unit at Glenfield Hospital should be closed or should remain open. A long-running consultation on that topic has been held and is now closed. That decision will be made at national level and it is not possible now for us to make any contribution to the process.

What is going on now is the gathering of information about potential impacts of closing the unit at Glenfield - from our perspective, if this is done, how will it affect communities of religion or belief in the city (and in the county and Rutland)?

There are four options on the table and the final decision will favour one of them. In Option A, Glenfield stays open. In the other three options, Glenfield is closed and the nearest site for treatment is Birmingham Children's Hospital. Nothing more can be done at this stage to influence the eventual decision. Christina is very interested in seeing what we have to say in terms of foreseeable impacts of the closure - and, just as importantly, ways of mitigating those impacts.

The response from Leicester Council of Faiths to this part of the consultation process is shown below. This was circulated around our Board of Directors and their comments solicited before it was submitted.

"Safe and Sustainable – A New Vision for Children’s Congenital Heart Services"

Response from Leicester Council of Faiths, drafted following a meeting with Christina Marriott, Manager of the Integrated Equality Service at Leicestershire Partnership NHS Trust HQ, Lakeside House, 4 Smith Way, Grove Park, Enderby, Leics LE19 1SX, Monday 28 May 2012.

This response has been made as promptly as possible, but it should be noted that it is still a provisional one. There is a clear need to keep talking and keep thinking about the possible impacts of rationalising Children’s Congenital Heart Services nationally. If, as a result of decisions made at national level, Glenfield Hospital does not retain its surgical unit, then deeper consultation will be required, perhaps including direct engagement with representatives of different communities of Religion or Belief in the city, county and Rutland.

We appreciate the fact that the Joint Committee of the Primary Care Trust (JCPCT) is showing due regard to the groups it serves in Leicester, Leicestershire and Rutland. We are aware that the conversation with Leicester Council of Faiths is part of a wider ongoing process of consultation, in which JCPCT is talking with other organisations representing people and groups identifying with Protected Characteristics as enumerated in the Equality Act 2010. We know that that these groups include, for example: Leicester Lesbian, Gay, Bisexual and Transgender (LGBT) Centre; Leicestershire Centre for Integrated Living (LCIL); and The Race Equality Centre (TREC). In the context of this knowledge, we hope that nothing in this response will come across as special pleading on behalf of those people and groups who identify with the Protected Characteristic of Religion or Belief. We welcome and support the involvement of a wide range of stakeholders and expertise in the consultation.

JCPCT has to demonstrate awareness of possible or likely impacts on families, groups and / or communities who identify with the Protected Characteristic of Religion or Belief – and to show that proportionate actions that may be taken in mitigation of those impacts have been discussed, recorded and forwarded to those involved in deciding the outcome of this review.

Given the nature of the Protected Characteristics enumerated in the Equality Act 2010, we are aware that many of them overlap, meaning that individuals, families and communities identifying with any Religion or Belief will most likely also identify with one or more of the other Protected Characteristics (i.e. age, disability, marriage and civil partnership, pregnancy and maternity, race, sex, sexual orientation, transgender). In keeping with the current understanding of equality, it is clear that communities, families and individuals no longer align themselves with just one characteristic, but tend more to see themselves as bundles of characteristics. Sometimes these bundles work in harmony with each other within the same community, family or individual, at other times they may compete with each other. At times, one of these Protected Characteristics may come to the fore and be of greater importance, or it may fade into the background and be superseded in importance by others. For example, it may be the case that sometimes individuals, families or groups who identify with the Protected Characteristic of Religion or Belief may speak out more strongly on an issue related to age or disability.

Anyone who identifies with any particular Religion or Belief wants to obtain the same level of service in hospital as any other person: adaptable, competent, sensitive and well-trained staff at all levels; clean and well-kept wards, free from risk of infection; speedy responses by staff members and by NHS institutions to changing needs and situations; the willingness and ability to treat patients, family and visitors as whole people.

People of Religion or Belief are, in the end, people after all. They do not necessarily bring special problems associated with Religion or Belief with them. However, there are particular needs associated with the Protected Characteristic of Religion or Belief, which we hope can be clarified here.

One issue that will surely be raised by all respondents is increased travel time between a unit in Birmingham and home in Leicester, Leicestershire or Rutland. Given that the patient is a child, it’s normal to have an adult family member with the patient at all times, if possible. Family members tend to work in shifts by the patient’s bedside (assuming that a sufficient number of family members are available to do this). This will normally bring about considerable disruption to the family’s routine – which is of special significance if that routine involves playing an active part in the community life of their place of worship. We would want to be assured of decent facilities for parents and/or other family members  to sleep when staying with the patient, and not be subjected to the ordeal of travelling longer distances (especially if they have to drive).

It’s fairly easy to come up with a wish-list that would appear to cover the bases in terms of the Protected Characteristic of Religion or Belief (e.g. family and visitors have access to a well-maintained prayer room or quiet room; appropriate washing facilities for ritual ablutions; a range of sacred scriptures and other appropriate texts in a variety of languages; a display of artifacts and/or symbols for devotional use; food and drink that fits in with Halal, Kosher and vegetarian and vegan dietary regimes). Such a list is important, of course – but in this day and age, these things may be said to be the minimum that would be expected under any circumstances. In relation to these requirements, we would be concerned that, if the unit at Glenfield were to be closed, one impact would be a squeeze on existing facilities, an increase in demand, that could not be coped with comfortably. To mitigate this impact, there would need to be, at the very least, an expansion of such facilities existing at Birmingham Children’s Hospital, in close proximity to the site of Congenital Heart Services.

Over and above all this, however, there is another kind or level of response from the perspective of the Protected characteristic of Religion or Belief, a more nuanced and subtle one, which we would like to see taken into account.

The city of Leicester is known for its distinctive religious profile. If the surgical unit at Glenfield Hospital is to close as a result of this national review, then the religious profile of potential service users from Leicester has to be taken into account for effective functioning of the site to which Leicester-based patients will be referred.

In terms of this religious profile, can we be sure that appropriate training has been or will be given to staff on those other sites, that suitable resources have been or will be made available (to service users and staff), that a relevant multi-faith chaplaincy service is currently or will be accessible (to all who may need it)?

What is the religious infrastructure locally? Even if another city is known for diversity in its own right (e.g. Birmingham) it should not be assumed that this will match up with the sort of diversity found in Leicester. While it is important to be able to demonstrate that Religion or Belief has been taken as seriously as the other Protected Characteristics, it is also important to be able to show that the issue of diversity has been considered to the same degree. There is no generic, universal, “one size fits all” solution to issues that arise in relation to Religion or Belief. There will be variation, perhaps tension (if not actual conflict) between the needs or wishes of different communities of Religion or Belief. There may be competing demands on resources, space or funding that means if one thing is done, another cannot. This may be the case not only between distinct communities, but also within those communities themselves.  When it comes down to it, it may be said that no two families who identify with a particular Religion or Belief may be expected to respond in the same way.

In the midst of all this discussion of equality and diversity, care should be taken not to make it look as though nominal affiliation to the Church of England is “normal”, even for families with no particular religious affiliation.

Issues related to end of life care assume the greatest importance for families who identify with a particular Religion or Belief. Under such circumstances, the stakes are obviously raised. A religious person will probably want to pray more, preferably at their chosen place of worship, for the recovery and well-being of the child. If they are unable to attend their normal religious services or observances, this will put an extra strain on family members.

This potential impact would be mitigated if relevant staff know the location of places of worship (with proper awareness of differences between denominations, sects, etc.). This kind of knowledge can be captured in a multi-lingual resource, but should also be part of the family and patient’s initial care plan. This sort of conversation should be triggered when a child is scheduled for surgery. It would mitigate all kinds of impacts to be able to “front-load” the service in this way, rather than end up trying to take remedial action.

This response submitted by George M Ballentyne, Equality & Diversity Officer, Leicester Council of Faiths, 28 May 2012

STAFF BRIEFING AT BEAUMONT WARD, BRADGATE MENTAL HEALTH UNIT

At Bradgate Mental Health Unit, Glenfield Hospital this afternoon, promoting the NHS Staff Multi-Faith Resource that Leicester Council of Faiths has helped produce for Leicestershire Partnership NHS Trust (LPT).

I'm here with Abida Hussain, Equality and Human Rights Officer in the Integrated Equality Service for LPT and the city and county Primary Care Trust (PCT) cluster, as we continue the process of briefing those most likely to use this resource.

We’re here specifically to meet staff at Beaumont Ward. It's the second time we've come to this ward. On our first visit to the Bradgate Mental Health Unit (see blog entry for Friday 13 January) we were booked to visit five wards in one afternoon. We met staff in Ashby Ward, Aston Ward and Heather Ward and were also booked to see staff on Beaumont Ward (and Belvoir Intensive Care Unit for that matter) but Beaumont was almost entirely bank staff that day, so we rescheduled this visit.

INVOLVEMENT CENTRE AT BRADGATE MENTAL HEALTH UNIT

Abida Hussain and I fetch up at the Bradgate Mental Health Unit, Glenfield Hospital an hour or so before our appointment at the Belvoir Intensive Care Unit, where we're scheduled to deliver one of our briefings on the NHS Staff Multi-Faith Resource this afternoon.

This is the second time we've been booked to visit Belvoir ICU. On our first visit (13 January) there had been some miscommunication and our visit hadn't been entered in the ward diary, so we couldn't deliver the briefing. We thought we should call in early this time, to make sure that we're in the diary for today. We're not. Faced with rescheduling again, we decide to come back at 1400, the time we'd booked, even if it means we'll only be speaking to a couple of staff members today.

In the meantime, we head for the Involvement Centre, to get a coffee and kill some time till our meeting at Belvoir ICU. This turns out to be serendipitous. On entering the Involvement Centre, I'm pleased to see Grant Paton (photo above, at his post), whom I've known for years now, from my time at Network for Change, who is volunteering here. He sits with us and talks about the Involvement Centre, with lots of enthusiasm. We're joined by Louise Maine, member of staff in charge of the centre. Over the next 20 minutes or so, we agree that we'll come in and do one of our briefings on the NHS Staff Multi-Faith Resource for the volunteers in the Involvement Centre (actually, two such sessions in the next few weeks). We also float the possibility of us providing briefings for the groups and organsiations who support the Involvement Centre, such as Genesis and LAMPdirect.

I promised Grant that I'd big up the Involvement Centre on the blog, so here it is:

Who is the Involvement Centre for? Everyone.

What is it? A place where people can meet and work in partnership with LPT to improve services.

Where is it? At the Bradgate Unit site.

Why have one? Because service users, carers and local groups asked for an involvement centre.

What's in it? Coffee shop, desk space, meeting tables, wi-fi access, information on services and all issues that people may want to know about who are seeking care and treatment.

Who will be there? Volunteers, service users, carers, local groups.

What will it offer? PALS (Patients Advice and Liaison Services), meet the manager, gather people's thoughts and opinions.

Do I have to go to the centre? It's up to you. It's not a day care centre or a drop in centre. It's only the second in the country.

Yes, but what does it do?

• it provides a dedicated space where the service user and carer groups can book space, meet, network and use shared facilities.
• it will support commissioned service user and carer groups to develop in-reach and out-reach services
• it will support the development of social enterprise groups and provide opportunities to network
• recruit people to become Foundation Trust Members
• recruit people to become volunteers
• offer opportunities for people to engage in arts and sports
• provide access to Patients Advice and Liaison Services
• provide access to Welfare Rights and benefits services
• provide access to Spiritual and Pastoral Care services
• provide access to advocacy services
• provide access to employment facilitators
• provide information on local groups, services, education, employment
• provide information for people's health and well-being and host "Let's Talk About Health" events
• signposting people to available groups and support that may need to be language, faith, age, culture and sexuality specific
• work with service users and carers to develop and undertake questionnaires, surveys and research projects which will serve to improve care services
• provide a variety of ways for people to express their views, e.g. electronic, 1-1, meetings, groups, advocates, PALS, "Listening and Working Together" events

INTER FAITH WEEK, DAY 4: NHS STAFF MULTI-FAITH RESOURCE BRIEFING AT MANSION HOUSE

At Mansion House, Glenfield Hospital this afternoon, promoting the NHS Staff Multi-Faith Resource (or "Multisave" as its billed on the whiteboard in reception) that Leicester Council of Faiths has helped produce for Leicestershire Partnership NHS Trust (LPT).

I'm here with Abida Hussain, Equalities and Human Rights Officer in LPT's Integrated Equality Service, as we continue the process of briefing members of LPT staff most likely to use this resource.

This is the second of three lunchtime briefings this week which we (and LPT) are counting as part of our respective activities for Inter Faith Week.

FMO BACKS CAMPAIGN FOR GLENFIELD HEART CENTRE

This press release has been circulated on behalf of the Federation of Muslim Organisations (FMO) by my friend and colleague, Suleman Nagdi. Leicester Council of Faiths supports this campaign and we'll be issuing our own statment of support in the next week or so.

Muslim group says Hold on to our Hearts

The Federation of Muslim Organisations (FMO) has joined the campaign to hold on to children's heart services at Glenfield Hospital.

The influential group, which represents just under 200 Muslim organisations, says it strongly supports the campaign to save the East Midlands Congenital Heart Centre at Glenfield Hospital which is in real danger of closure.

Spokesman for the FMO Suleman Nagdi MBE DL said: "The fact that such an outstanding and much needed service is in danger of closure is of serious concern. The heart unit has acquired an international reputation for success, being at the forefront of advancements in heart surgery as well as being home to a specialist ECMO unit.

"The closure of this unit will be a devastating development both locally and nationally.

"We are especially concerned at how this potential closure will affect the citizens of what will be the UK’s first ethnic majority city, with over 150,000 Asians, many amongst whom the prevalence of heart disease is particularly high and how plans for the closure have been made without the consultation of bodies representing this ethnic majority such as the FMO."

The East Midlands Congenital Heart Centre, based at Glenfield Hospital, serves a population of more than 5 million across the East Midlands and cares for patients with congenital heart disease from before they are born and into adulthood.

The surgical centre faces an uncertain future as a national review into the care of children with congenital heart conditions aims to close some of the existing centres.

A public consultation into which set of surgical centres should continue to carry out heart surgery is being carried out until Friday 1 July. The centre at Glenfield is included in just one of the four options being put to the public - option A - this means if any of the other three options are chosen the centre at Glenfield would close.

The centre at Glenfield Hospital is part of the highest rated option to provide a safe and sustainable service for the entire country.

"I urge all members of the community to campaign against the closure of the unit by filling in the NHS survey at www.ipsos-mori.com/safeandsustainable and choosing option A, he adds.

Birthday of Bahá’u’lláh celebrated in Glenfield

To the Parish Council Hall in Glenfield, Leicestershire, this evening, to join city and county Bahá'ís in celebrating the Birthday of Bahá’u’lláh, founder and central figure of the Bahá'í Faith. We're not quite sure where we're going and neither is the taxi driver. Having driven the length of Stamford Street once, then turning round at the bottom only to drive all the way back up again,we ask him to stop and let us out so that we can ask directions in one of the shops. After several minutes up hill and down dale, we find the venue, which is set well back from the main road and not terribly well lit or signed. We arrive just as the devotional part of the meeting is ending.

This is the first outing for the Flip video camera and I'm at a bit of a loss what to film at first. I settle on the format of talking heads, interviewing five of the friends here - Aramesh, Jan, Khaze, Mateen, Rita - about this occasion (with some of them, I use the Council of Faiths Bahá'í banner as a backdrop). This seems promising; an adaptable format, in which being rough and ready will look live a virtue (I hope). I might be better at cinema verite than aiming at something more polished. Back at home, I launch a YouTube channel for Leicester Council of Faiths, with these five being the first things uploaded to it.

See these first videos posted to the Council of Faiths YouTube channel:
http://www.youtube.com/user/counciloffaiths#grid/user/FEA51F841560D18B

CreativeCoffee Club (6)

It's the fortnightly meeting of CreativeCoffee Club at Phoenix Square Digital Film and Media Centre. No speaker, no particular topic this morning, but a little more formal and structured than our last meeting two weeks ago. We've moved out of the Screen Lounge cafe bar into one of the education suites upstairs. Or perhaps we have been moved out - there's a suggestion that last time there were so many of us that we took up too much space and encroached on a meeting of the University of the Third Age (U3A), who gather in the Scfreen Lounge cafe bar before going into a special showing of a film just for them. Last time they were waiting to see Stanley Kubrick's 2001, A Space Odyssey. Well, that shows that they've got stamina. They should put that on a double bill with Kubrick's Spartacus, with a break in between in case anyone needs to shave.

Some of the core members are here (Ben, Farhanah, Ian, Mel - who all cross over with Amplified Leicester) but there are another dozen or so, for whom  it's their first time here. We've got two minutes each to introduce ourselves and pitch our business, service, whatever it is we bring to the table. Jayne keep time with the stopwatch on her iPhone. When it's my turn, I take the opportunity to hand round bookmarks, postcards, flyers and my business card for the Council of Faiths. How come I'm the only one to do that today? I'd have thought stuff like that would be Networking 101.

After all the intros, we can move back downstairs to the cafe bar, as the U3A people have cleared the space. Not much time to get into conversation today, as I have to dash off to my next appointment at Voluntary Action Leicester, starting 12 noon.

I should mention that this morning I've taken the opportunity to collect some signatures on the Heart Link petition to support the continuation of children's surgery and cardiac services at Glenfield Hospital.