This meeting of the Clinical and Adult Social Work Governance Committee will receive an update on the work done by Clinical & Care Risk Management Group, and their efforts to ensure a standardised approach to the management of clinical risks. The committee will also consider a report on the challenges associated with the use of Locum Consultants and Consultant Psychiatrists, and will receive an update on the ongoing support being provided to Asylum Seekers in Westhill.

Asylum Seeker Support - Westhill

This item is included on the agenda to update the committee on the support being offered to Asylum Seekers residing at the Hampton by Hilton hotel in Westhill.

The report notes that there is significant strain on Skene Medical Group, the GP practice that covers the hotel, due to the increased population.

As of 14 November 2024, 277 asylum seekers were residing in the hotel, which has a maximum capacity of 341.

Separate additional funding has been secured from the Local Authority to continue the Health Assessment Team (HAT) up to March 2026

The report states that a Stakeholder Group, which continues to meet, is currently finalising an options paper on how the group can work with Skene Medical Group to alleviate pressures and support sustainability.

Locum Budget Pressures

This report updates the committee on the financial and clinical risks associated with the use of Locum Consultants and Consultant Psychiatrists in Aberdeenshire.

The report states that the partnership is facing an overspend on locum cover, which is excaerbated because of a significant number of recent retirements.

It goes on to explain that:

There is a significant risk that by the budget year end, if the current situation re reliance on Locum provision is not reversed, the current whole service allocated budget (circa £1.8m) will be circa £2m overspent.

The report discusses the challenges of persuading existing locum staff to move to a Direct Engagement contract, which would allow NHS Grampian to make significant savings in VAT payments.

NHSG colleagues dispute [the assertion that locum doctors are self-employed] and have provided HMRC employment status assessments to several agencies which support the view that the medical agency Locums should be treated as employed for tax purposes and deductions should apply.

A number of options for mitigating the risks associated with the over-reliance on locum doctors are discussed, including:

• Tightening job planning.
• Reducing locum contracts to one month in length.
• Offering all future contracts to locums who agree to Direct Engagement first.
• Pooling all Consultant Psychiatry budgets.
• Advertising vacant substantive posts.

Clinical & Care Risk Management Group Update

This briefing note provides an update on the work of the Clinical & Care Risk Management Group (CCRMG), which:

... supports good governance and the delivery of safe, effective and person centred care.

The briefing explains that:

Significant progress was made during 2023 to standardise data capture and reporting processes for the teams and services who report to the CCRMG.

The CCRMG has recommended some minor changes to its terms of reference, including changing its name from PRG to Clinical & Care Risk Management Group . The briefing clarifies that:

This will allow a clearer separation from matters which fall under the remit of the Risk and Assurance Group...

The CCRMG is also working to improve the management of complaints from members of the public:

... and will allow for complaints to be responded to in a timelier and more localised manner.

The briefing then provides a summary of adverse events between 1 January and 30 September 2024. The data shows that there were 2,978 adverse events recorded on Datix during this period, an increase of 21% on the same period in 2023.

Risk Register and Risk Assurance

The committee will consider a report on the work of the Clinical and Adult Social Work Group (CASWG) in relation to risk reviews. The report explains that:

All staff and managers identify risks as part of their role. Operational risks are captured locally by staff and managers as part of the risk assessment process. Any risk which has an organisational or significant impact is held on the Datix risk register - as an IJB, strategic, clinical and care or resource risk.

The report then provides a summary of the risks reviewed at recent CASWG meetings.