NATIONAL CARE STANDARDS COMMITTEE MEETING
Rosebery House, Edinburgh, Friday 6 June 2003
Note of the Meeting
Present: Adam Rennie (Chair), Colin Anderson, Pek Yeong Berry, Lorraine Briggs, Pat Dawson, Jacqueline Hughes, Mary McCann, John McKenzie, Janis Pelosi, Jacquie Roberts, Frances Smith, David Whiteoak, Carol Wilkinson, Marjory Barquist (Secretary)
1. Apologies
Apologies were received from: Doreen Campbell, Val Cox, Sally Evans, Linda Gregson, Jim McDonald, David Souter, Janie Allan, Gordon Masterton and Robert Houtman.
2. Welcome
Adam Rennie welcomed everyone to the seventh meeting of the National Care Standards Committee.
3. Note of Last Meeting and Matters Arising
3.1 There were no action points from the last meeting. The Committee had agreed at the last meeting that, once the agreed changes were made to the Childcare Agencies standards, they could be submitted to Ministers for final sign off. Adam advised that the changes had been incorporated and that the standards were likely to be published and distributed by the end of June.
3.2 The notes of the last meeting were agreed.
4. Update on Medical Practices draft standards
Lorraine Briggs gave an update on the work of the medical practices group. The group last met on 30 May. As requested by the NCSC a representative from an advocacy service had been recruited to the group and they attended the meeting. Unfortunately attendance at the meeting had been low. The group had discussed and amended the list of 'useful questions' that had been developed earlier in the year. The work on the standard 'people attending for mental healthcare' would be considered at the next group meeting.
5. Update on the New Dental Services Working Group
5.1 Marjory Barquist gave an update on the progress of the work on the Dental Services standards. As agreed by the working group, the Secretariat had met with Care Commission and NHS QIS colleagues to draft a set of combined standards. The working group would meet again on 16 June when it would consider this draft.
5.2 The Committee was asked to consider what procedure should be adopted to sign off the combined standards. In response to a question about how NHS QIS signed off standards Frances Smith confirmed that this does not normally involve the NHS QIS Board. Each set of standards is signed off by the project group with responsibility for developing that particular set.
5.3 It was agreed that, as the combined approach that had been taken to the development of standards for dental practices was new and unique perhaps formal sign off procedure for the standards needed to be different to normal practice. After debating this further the Committee agreed that Adam would write to David Steel at NHS QIS about how best to sign off the combined standards.
6. Independent Specialist Clinics Standards (Paper 1)
6.1 Before discussion of the draft Independent Specialist Clinics standards there was some general discussion about the regulation of services. It was suggested that the NCSC should alert Ministers to limitations within the Regulation of Care (Scotland) Act 2001. There are a number of groups (such as au pairs, private nannies, nurses providing renal dialysis for holidaymakers) providing services which are not regulated under the Act. Adam pointed out that Ministers could use Statutory Instruments to extend the scope of the Act. As a first step, and in conjunction with the review of the standards, the Committee could identify the anomalies.
6.2 The draft before the Committee incorporated the changes made by the working group following the consultation and subsequent amendments made by the Independent Healthcare Panel. The Committee also had a copy of the report of the consultation responses that indicated whether the working group had accepted the comments and a list of the changes that had been made. In the absence of Frances McGeoch, chair of the working group, Lorraine took the Committee through the changes. Written comments provided by Robert Houtman were tabled for consideration.
6.3 Jacquie Roberts raised the question of Botox injections and whether these were covered by the standards for Independent Specialist Clinics. Other members of the Committee also took up this matter and raised additional issues in relation to the scope and interpretation of the Act. In the subsequent substantive discussion it was clarified that the scope of the Act in terms of independent clinics is limited to services provided by doctors or dentists and there are regulatory mechanisms other than the Care Commission e.g. for Botox the Medicines and Healthcare Products Regulatory Agency. However the Committee members continued to express concern and a need for more clarity.
6.4 It was agreed that clarification was needed on whether "provided by" a registered medical practitioner or registered dentist includes the overseeing of services actually given by others. Many cosmetic treatments are carried out by nurses, for example. It was agreed that the Secretariat would take advice from solicitors about this and report back.
6.5 The following action was also agreed:
Introduction - paragraphs three and four would be reworked to make them clearer and an additional paragraph would be inserted to advise users to consult the Care Commission if their treatment is delivered outwith the context of an Independent Specialist Clinics;
Some additional information on the Obesity Management Association (OMA) and on the Royal College of Physicians (RCP) guidance on appropriate prescribing and management of anti-obesity drugs would be required before footnotes 7 and 17 are agreed;
The professional organisations in the glossary would be grouped together and the definition of NMC would be expanded;
Standard 10.7 - check what other standards say about food and drinks and consider rewording this standard;
The paragraph drafted by NHS QIS and the Care Commission on the links between the organisations for the introduction would be submitted to Violet Jardine to 'plain English'.
6.6 The Committee agreed that the amendments to the standards could be sent to members by email. However, in view of the preceding discussions, the final draft would need to be seen again by the Committee at a meeting for final sign off.
7. Review of the National Care Standards (Paper 2)
7.1 Adam invited comments on the paper, which updated the Committee on the work being done in relation to the review. Jacquie endorsed the paper and commented that encouraging feedback from those using the standards was a positive step.
8. AOCB
There was no other business.
9. Dates of next meeting and future meetings (Paper 3)
9.1 The next meeting will be held on Friday 15 August 2003 in Conference Room 3, Victoria Quay from 10.30am .
9.2 Subsequent meetings have been arranged as follows and will also be held in Conference Room 3 at Victoria Quay:
Monday 29 September 2003
Monday 27 October 2003
Monday 24 November 2003
9.3 It was agreed that meetings for January to June 2004 should also be scheduled.