Agenda and minutes

The Chair welcomed both new and returning Members to this Committee for 2011/12.

Apologies for absence were received from Councillor Hubbard and his Substitute Councillor Weavers; Councillor Webster; Colin Throp, Deputy Chief Executive & Finance Director, Southport & Ormskirk Hospital NHS Trust; and Paul Acres, Chairman, NHS Sefton.

Members and Officers are requested to give notice of any personal or prejudicial interest and the nature of that interest, relating to any item on the agenda in accordance with the relevant Code of Conduct.

The following declaration of interest was received:-

Minutes of the meeting held on 1^st March 2011.

That the Minutes of the meeting held on 1^st March 2011, be confirmed as a correct record.

Report of the Director of Corporate Commissioning.

The Committee considered the report of the Director of Corporate Commissioning explaining the function of Overview & Scrutiny Committees and the remit of this Committee in particular, especially for the benefit of newly-elected Members.

The report outlined the establishment of local government scrutiny under the Local Government Act 2000; overview and scrutiny in Sefton MBC; the general role of overview and scrutiny committees; their specific functions; the facility for any member of an overview and scrutiny committee to request a relevant matter to be included on an agenda; policy development and review in the form of working groups; the facility for officers and members of the executive to be called to give account; call-in of executive decisions and the procedure to be followed for urgent executive decisions; the annual reports from overview and scrutiny committees to full Council; the scope of this Committee and its terms of reference.

Councillor Griffiths requested the possibility of an item on IVF to a future meeting. The Chair requested Dr. Janet Atherton, Director of Public Health, NHS Sefton and Sefton MBC to outline information on IVF within Sefton under Item No. 16 below.

RESOLVED:

That the report be received.

Report of the Director of Corporate Commissioning.

The Committee considered the report of the Director of Corporate Commissioning presenting information on quality accounts in order for Members of the Committee to comment on individual draft quality accounts received from healthcare providers.

The report set out the names of those local healthcare organisations that had provided this Committee with draft quality accounts for perusal and had invited comments on them.

The report also outlined the definition of quality accounts; who was required to produce and publish them; their aim and purpose; their intended use by the public and patients; the role of overview and scrutiny committees in reviewing draft quality accounts prior to their publication; and the voluntary role of overview and scrutiny committees in providing a formal statement on individual quality accounts.

The Chair reported that Aintree University Hospitals NHS Foundation Trust had originally submitted its draft Quality Account for consideration by this Committee but that it had been withdrawn from the agenda due to timing issues for the Trust. In addition, draft quality accounts had not been received from Clatterbridge Centre for Oncology NHS Foundation Trust or Liverpool Women’s NHS Foundation Trust, and the Chair suspected that those Trusts would be presenting their draft Quality Accounts to overview and scrutiny committees in neighbouring authorities.

RESOLVED: That

(1)       the report be received; and

(2)       the Committee’s comments on the draft quality accounts received from local healthcare providers be recorded under Items 7 to 11 below.

Kim Crowe, Executive Director of Service, Development & Delivery, Mersey Care NHS Trust, to attend and present the Quality Account.

The Committee considered the report of the Chief Executive of Mersey Care NHS Trust, summarising the Trust’s draft Quality Account for 2010/11. The report outlined the priorities of the 2009/10 quality account including improvements on the care pathway, the patient environment and stakeholder involvement. The report also set out outcomes against agreed priorities, together with refreshed priorities for 2010/11.

The Committee had previously been supplied with the full version of the Trust’s draft Quality Account.

Kim Crowe, Executive Director of Service, Development & Delivery, Mersey Care NHS Trust, referred to the priorities of the Trust’s previous Quality Accounts, together with those identified for priority within the Trust’s 2010/11 Quality Account. She also responded to Members’ questions on the Account and indicated that she would be willing to provide information on customer satisfaction surveys to Committee Members.

RESOLVED: That

(1)       the draft Quality Account for 2010/11 from Mersey Care NHS Trust be received;

(2)       Kim Crowe be thanked for providing information and responding to Members’ questions on the Trust’s draft Quality Account; and

(3)       the Committee looks forward to any appropriate visits to Mersey Care NHS Trust premises, to enable Members to acquaint themselves with the services provided by the Trust.

Tim Butcher, Assistant Director for Performance Improvement, North West Ambulance Service NHS Trust to attend and present the Quality Account.

The Committee considered the report of the Chief Executive of the North West Ambulance Service NHS Trust summarising the Trust’s draft Quality Account for 2010/11.

The Trust considered that it had made significant progress in developing quality of care within the organisation, seeking to make clear the message that quality of service was not solely down to the speed with which ambulances arrived on scene. The Trust was seeking to move to a service that identified the specific needs of the individual patient and selected the appropriate care package from a range of services available.

The Trust’s draft Quality Account reported on progress made in the five key areas for service improvement, namely end of life care frequent callers; chain of survival and complementary resources;acute stroke care; and heart attack.

The Account also reported on achievements over the previous year, covering the following topics, using the national headings of safety, effectiveness and experience:-

Patient Safety

Safeguarding Children and Vulnerable Adults;

Clinical Safety Incident reporting (CSIs); and

Infection prevention and control.

Clinical Effectiveness

Clinical Performance Indicators (CPIs); and

Thrombolysis/Reperfusion.

Patient Experience

Access;

Patient and public engagement; and

Complaints, PALS and compliments.

The Committee had previously been supplied with the full version of the Trust’s draft Quality Account.

Tim Butcher, Assistant Director for Performance Improvement, North West Ambulance Service NHS Trust, outlined the Trust’s draft Quality Account for 2010/11, together with the work of the Trust in general, and responded to Members’ questions on the Trust’s Account and service provision.

A number of Members referred to specific occasions when they had experienced Trust services and they were highly complimentary of the service they had experience.

RESOLVED: That

(1)       the draft Quality Account for 2010/11 from the North West Ambulance Service NHS Trust be received;

(2)       Tim Butcher be thanked for providing information and responding to Members’ questions on the Trust’s draft Quality Account and the Trust in general; and

(3)       the Committee looks forward to receiving future reports on the Trust’s service and to any appropriate visits to Trust premises, to enable Members to acquaint themselves fully with the services provided.

Denise Carroll, Director of Clinical Governance and Quality and Diane Wake, Director of Nursing and Operations, to attend and present the Quality Account.

The Committee received a presentation from Denise Carroll, Director of Clinical Governance and Quality and Diane Wake, Director of Nursing and Operations, Royal Liverpool & Broadgreen University Hospitals (NHS) Trust, on the Trust’s draft Quality Account for 2010/11, and the work of the Trust in general. They also responded to Members’ questions on the Account and general service provision and indicated that the Trust had produced a pamphlet on abbreviations used in service provision which they would be willing to provide to Committee Members.

The Committee had previously been supplied with the full version of the Trust’s draft Quality Account.

RESOLVED: That

(1)       the draft Quality Account for 2010/11 from the Royal Liverpool & Broadgreen University Hospitals (NHS) Trust be received;

(2)       Denise Carroll and Diane Wake be thanked for providing information and responding to Members’ questions on the Trust’s draft Quality Account and the Trust in general; and

(3)       the Committee looks forward to any appropriate visits to Trust premises, to enable Members to acquaint themselves with the services provided by the Trust.

Lisa Grant Assistant Director of Nursing and Governance, Walton Centre for Neurology and Neurosurgery NHS Foundation Trust to attend and present the Quality Account.

The Committee considered the report of the Chief Executive of the Walton Centre for Neurology and Neurosurgery NHS Foundation Trust summarising the Trust’s draft Quality Account for 2010/11. The report outlined a Statement of Quality from the Chief Executive. The Improvement Priorities and Statement of Assurance from Board focussed on priorities for 2010/11 which were patient safety; patient falls; infection control; clostridium difficile; meticillin-resistant staphylococcus aureus (mrsa) bacteraemia; and medication errors.

Effectiveness focussed on the areas of pressure ulcers; venous thromboembolism (vte); and patient reported outcome measures (proms).

Patient Experience focussed on the areas of patient food; discharge information; and complaints

Improvement Priorities for 2011 – 2012 were patient safety; patient effectiveness; and patient experience.

Statements of Assurance from the Trust Board included participation in clinical audit and national confidential enquiries; participation in clinical research and development; CQUIN framework; Care Quality Commission (CQC) registration; and trust data quality.

The Trust Overview of Quality 2010/11 included Local Engagement through the Quality Account; Safety Node 2010 – 2011; Safety Express 2011 – 2012; and Dignity Champions 2010 – 2011.

An Overview of Performance in 2010/11 against National Priorities from Department of Health’s Operating Framework was also set out.

The Committee had previously been supplied with the full version of the Trust’s draft Quality Account.

The Committee also received a presentation from Lisa Grant, Assistant Director of Nursing and Governance, Walton Centre for Neurology and Neurosurgery NHS Foundation Trust, on the Trust’s draft Quality Account for 2010/11, and the work of the Trust in general.

Lisa Grant responded to Members’ questions on the Account and reported that the Trust was currently in the process of producing a 2 year strategy on patient experience with the Trust. She indicated that she would be willing to provide this to Committee Members on its publication in July 2011.

RESOLVED: That

(1)       the draft Quality Account for 2010/11 from the Walton Centre for Neurology and Neurosurgery NHS Foundation Trust be received;

(2)       Lisa Grant be thanked for her informative presentation;

(3)       the Committee looks forward to appropriate visits to Trust premises, to enable Members to acquaint themselves with the services provided by the Trust.

Colin Throp, Deputy Chief Executive & Director of Finance, Southport & Ormskirk NHS Trust to attend and present the Quality Account.

The Committee had previously been supplied with the full version of the Southport and Ormskirk NHS Trust’s draft Quality Account.

Having received apologies from Colin Throp, Deputy Chief Executive and Director of Finance, Southport and Ormskirk NHS Trust, no-one was present at the meeting to present the Trust’s draft Quality Account for 2010/11.

RESOLVED:

That the draft Quality Account for 2010/11 from Southport and Ormskirk NHS Trust be received.

Further to Minute No. 94 (3) of 1^st March 2011, Kim Crowe, Executive Director of Service, Development & Delivery, Mersey Care NHS Trust, to give a presentation.

Further to Minute No. 94 (3) of 1^st March 2011, Kim Crowe, Executive Director of Service, Development & Delivery, Mersey Care NHS Trust, gave a presentation on “No Health Without Mental Health”, a cross-government mental health outcomes strategy for people of all ages.

The presentation outlined the following:-

Strategy Objectives

• More people would have good mental health and wellbeing;
• A growing number of people with mental health problems would recover;
• More people would have good physical health;
• More people would have a positive experience of care and support ;
• Fewer would suffer avoidable harm; and
• Fewer would experience stigma and discrimination.

The presentation also outlined Key Issues and Local Actions, including the following:-

Interconnection between mental health, housing employment and the criminal justice system

• assess housing and employment status as part of care planning;
• employment advisers in community teams;
• pilot site for National Diversion program - Bradley Report; and
• multi-agency approach to care.

Strategy applied to all ages:

• family support workers;
• keeping The Family in Mind (Barnardos);
• Early Intervention Services;
• joint work with Alder Hey;
• dementia Strategy; and
• dementia Quality, Innovation, Productivity and Prevention (QIPP).

Economic case for improving mental   health and well being:

• further investment in NICE approved psychological therapies; and
• reduction in costs to NHS predicted.

Anti-Stigma

Mersey Care had signed up to the Time To Change Campaign.

Mental Health QIPP

• care pathways;
• primary care mental health services;
• community mental health services; and
• out of area treatments.

Dementia QIPP

• general hospitals;
• care homes;
• home support; and
• use of antipsychotic drugs.

New suicide prevention strategy for England

review of Mersey Care strategy

Public health and recovery emphasis

• Imroc Project; and
• 5 Ways to Wellbeing.

Kim Crowe also circulated “A Call to Action”, a statement signed by representatives of a number of organisations that had pledged to work together to deliver the government’s outcomes strategy, and answered questions posed by Members on the strategy.

RESOLVED: That

(1)       Kim Crowe be thanked for informative presentation; and

(2)       the presentation be received.

Dr. Janet Atherton, Acting Chief Executive, NHS Sefton, to provide a verbal update.

Dr Janet Atherton, Director of Public Health, NHS Sefton and Sefton MBC gave a presentation on the NHS in Sefton and the range of services provided, together with a brief overview of how the NHS reforms would impact on Sefton.

The presentation outlined the following:-

The NHS in Sefton - About NHS Sefton

•         Responsible for the health and healthcare for 270,000 residents;

•         Budget of £500m+;

•         Keeping people healthy;

•         Tackling health inequalities;

•         Ensuring high quality healthcare available for those who need it:

- Prevention to end of life; and

- Provided by NHS, voluntary and private organisations.

Analysis of NHS Sefton spend for 2010/11

                        Area                                                               Spend £M

            Secondary Care Services                                       319

            Primary Care Services                                             66

            Prescribing                                                                49

            Community Services                                                58

            Public Health                                                             15

            Other                                                                           35

Services

•         Primary and community services:

- Doctors, dentists, optometrists, pharmacists;

- Healthy lifestyle services; and

- Health visiting, district nursing.

•         Specialist secondary care services:

- Southport and Ormskirk NHS Trust;

- Aintree University Hospitals NHS Trust;

- Specialist NHS Trusts eg. Mersey Care, Walton Centre, Liverpool Heart and Chest.

Improvements in last year

•         Reducing waiting times;

•         New dental centre in Bootle;

•         Improved care of patients with lung disease, reducing hospital admissions;

•         Children’s services hub in Southport;

•         Personal health budgets for people with mental health problems; and

•         4000 people had lifestyle checks for heart disease and diabetes.

NHS Policy changes

•         Liberating the NHS, Health and Social Care Bill

- GP consortia and Health and Wellbeing Boards to replace PCTs at local level; and

- Merseyside PCT Cluster being created to help manage the transition period.

•         Healthy People, Healthy Lives

- Public health policy; and

- Leadership role for Councils in public health.

RESOLVED: That

(1)       Dr. Atherton be thanked for her informative presentation; and

(2)       the presentation be received.

Dr. Neil Leonard, Chair of Southport and Formby Practice-Based G.P. Consortium, to provide a verbal update.

The Committee received a verbal update from Dr. Neil Leonard, Chair of Southport and Formby Practice-Based G.P. Consortium, who reported on the impact that the NHS reforms would bring. GPs would be further accountable for resources in the future and required to improve on primary care provision. He considered that the changes would require GPs to think more corporately in the future and that the main public health issue that could be tackled was that lifestyles could be improved.

Dr. Leonard also responded to questions from Members on the matter.

RESOLVED: That

(1)       Dr. Leonard be thanked for attending the Committee to respond to questions from Members; and

(2)       the presentation be received.

Report of the Deputy Chief Executive & Finance Director, Southport & Ormskirk NHS Trust.

The Committee received a briefing paper from the Chief Executive of Southport and Ormskirk NHS Trust providing Committee Members with an update about some of the Trust’s recent work. Information was provided on the following:-

A.        Integrated Care Organisation (ICO)

The formal process of setting up the new organisation, to provide acute and community care across the North Sefton/West Lancashire footprint, had been concluded. The ICO would deliver improvements in the patient’s experience as well as care in the most appropriate setting. The Trust would also ensure that it maximised the efficient use of the limited resources available.

B.        Foundation Trust Status

All NHS Trusts were required to achieve NHS Foundation Trust status by April 2014 and the briefing paper set out developments for the Trust in this matter.

C.        The Financial Challenge

The briefing paper set out details of the financial challenges facing the Trust, including redundancy options, voluntary or otherwise.

D.        Dermatology

The community elements of the Dermatology service based at the Trust will no longer be provided by the Trust, rather from April 2011 it would be provided by a company that had tendered for the provision of the service.

Having received apologies from Colin Throp, Deputy Chief Executive and Director of Finance, Southport and Ormskirk NHS Trust, no-one was present at the meeting to present the Trust’s briefing paper.

RESOLVED:

That formal consideration of the briefing paper from Southport and Ormskirk NHS Trust be deferred until such time as a representative of the Trust attends the Committee.

Report of the Acting Chief Executive, NHS Sefton.

The Committee considered the report of the Acting Chief Executive, NHS Sefton, on current issues impacting on healthcare provision within Sefton, as well as developments around the national changes to the NHS.

Information was provided on the following:-

A.        Update on NHS Reforms

a) National developments

(i)        Following a decision to ‘pause’ the passage of the Health and Social Care Bill through parliament, the government’s ‘listening exercise’, seeking views about proposed reforms to the NHS, concluded at the end of May 2011. The changes set out in the Bill included the handover of commissioning of local health services from primary care trusts (PCTs) to GP consortia in 2013.

(ii)        The House of Commons Health Select Committee had issued an invitation to submit written evidence for its enquiry into public health as that Committee intended to scrutinise the changes to public health that would be legislated for in the Health and Social Care Bill.

b) Merseyside PCT Cluster

Following a requirement by the Department of Health for all PCTs to cluster by June 2011, work was on track to establish the Merseyside PCT Cluster, bringing NHS Sefton together with PCTs in Knowsley, Liverpool and Halton and St Helens. NHS Sefton would remain a separate organisation, its Board retaining accountability for the commissioning of local health services through the transition. Clustering would allow emerging GP consortia and Health and Wellbeing Boards to develop to ensure they were ready to take on their full statutory role in 2013. Individuals appointed to positions on the Merseyside PCT Cluster were identified within the report.

c) Sefton’s Practice Based Commissioners

NHS Sefton continued to provide support to the two Sefton Practice Based Commissioning (PBC) groups preparing to take on the statutory duties of GP consortia in 2013. NHS Sefton was supporting South Sefton PBC Commissioning Confederation and Southport and Formby PBC Commissioning Consortium. Both PBCs were developing local services to benefit their patients

B.        Re-Designed Dermatology Service Brings Care Closer to Home

From April 2011 a re-designed NHS community dermatology service had been operating in Sefton. The re-designed service continued to operate from Bootle Health Centre, Southport Centre for Health and Wellbeing, Ainsdale Centre for Health and Wellbeing and Formby Clinic, along with two additional venues, Litherland Town Hall Health Centre and Maghull Clinic. Some clinics would be open longer in the evening, while appointments were being offered to eligible patients living in care homes.

C.        Children’s ‘Hub’ Opens

Following a major review of children’s services in north Sefton, the new children’s health hub, based at Southport Centre for Health and Wellbeing, opened in June 2011, bringing together a range of different services such as community paediatrics, physiotherapy, child and adolescent mental health services and speech and language specialists. The hub would also play a central role in improving care for children and young people with long term conditions, disabilities and complex needs.

Dr Janet Atherton, Director of Public Health, NHS Sefton and Sefton MBC considered that it could be useful for Committee Members to  ...  view the full minutes text for item 16.

Report of the Chief Executive, Mersey Care NHS Trust.

The Committee considered the report of the Chief Executive, Mersey Care NHS Trust, on current issues facing the Trust. Information was provided on the following:-

A.        Integrated Corporate Performance Report for the Period Ending 31^st March 2011

The report set out details of the Trust’s performance score in the NHS Performance Framework for 2010/11. The trust achieved all key financial performance targets and details of the year end surplus, together with the financial risk rating, were provided.

B.        Foundation Trust Application

An update on the Trust’s progress in its application for full Foundation Trust status was provided.

C.        Quality Account

Progress on the production of the Trust’s 2010/11 draft Quality Account was provided. This matter is covered in greater detail within Minute No. 7 above.

D.        South Sefton Neighbourhood Project

This project sought to develop a whole system approach to the provision of community services. Traditional day hospital services would no longer be delivered in the way they had been historically and an alternative to day service provision within the community services would be developed, with more services being delivered to the population of Sefton via satellite services. Work was progressing on developing the Waterloo Day Hospital as a Neighbourhood Centre with design plans being developed to seek capital funding. The project commenced during March 2011 and was expected to be completed by April 2012. A project brief, providing further information was attached as an Appendix to the report, for further information.

Kim Crowe, Executive Director of Service, Development & Delivery, Mersey Care NHS Trust, indicated that she would provide further updates on this project at future meetings.

RESOLVED: That

(1)       Mersey Care NHS Trust be thanked for the report; and

(2)       that the update report be received.

Report of the Director of Older People.

Further to Minute no. 54 of 12^th October 2010, the Committee considered the report of the Director of Older People on progress in the implementation of the Sefton Dementia Strategy. Following the publication of the National Strategy, Living Well with Dementia – A National Strategy, a multi-agency group had been formed to deliver a Sefton Dementia Strategy.

The main themes of the National Strategy were raising awareness; early assessment and diagnosis; and living well with dementia.

Progress in recent months in Sefton included the following:-

·        The establishment of a Forum for the providers of dementia care services;

·        The first Living Well with Dementia conference was held in Southport in February 2011;

·        2011/12 Council tax notifications to Sefton residents included information about recognising signs of dementia and how to seek help;

·        A dementia workforce collaborative with Mersey Care NHS trust has been developed together with Liverpool and Knowsley Primary Care Trusts and Councils to explore opportunities to further integrate dementia education and training for health and social care staff across those localities.

In recent months, attention had focused largely on reviewing current dementia services as part of the Government’s Quality, Innovation Productivity and Prevention (QIPP)initiative to enable local authorities and the NHS to deliver their quality and efficiency commitments within the financial profile detailed in the Spending Review starting in 2011/12.

Proposals presented to NHS Sefton, NHS Knowsley and Liverpool PCT as Invest to Save initiatives aimed to ensure:-

• patients received the right treatment, at the right place, by the right professional through improved access and connectivity between services;
• increased productivity of existing services;
• prevention of unnecessary attendances at and admissions to secondary care (acute and mental health hospitals);
• provision of care at home, or closer to home, where possible;
• reduction in costs and increased value for money; and
• increased connectivity across the whole health and social care system.

If implemented in full by NHS bodies, the Dementia QIPP would make a significant contribution to the delivery of the Sefton Dementia Strategy.

Recommendations made by the former Dementia Working Group, established by this Committee, had also contributed towards the Sefton Dementia Strategy.

RESOLVED:

That the report outlining progress on local implementation of the Dementia Strategy during 2011 – 2014, be received.

Report of the Director of Corporate Commissioning.

The Committee considered the report of the Director of Corporate Commissioning submitting the most recent report by the Cabinet Member - Older People and Health for the period March to April 2011

RESOLVED:

That the Cabinet Member report be received.

Report of the Director of Corporate Commissioning.

The Committee considered the report of the Director of Corporate Commissioning in relation to the Committee’s programme of work. There were no items within the current Key Decision Forward Plan which fell under the remit of the Committee, on this occasion.

With regard to the Health Inequalities Working Group, that had reviewed health inequalities within the Borough, the final report had been submitted to the Cabinet during April 2011, and costed proposals for implementation would be considered by the Cabinet in due course.

The Chair and the two Party Spokespersons had been appointed by the Cabinet to the Joint Health and Well-Being Scrutiny Committee, comprised of Members drawn from Liverpool City Council, Knowsley Borough Council and Sefton Borough Council, which met to scrutinise health-related matters that impacted on residents of all three Council areas.

The report advised that throughout the Municipal Year Members of this Committee were requested to attend occasional site visits to organisations that provided health services to residents of the Borough, and the Committee was requested to consider any site visits to health providers during 2011/12. A number of possible future site visits had been raised during the course of this meeting.

The Chair requested that possibilities for working groups be considered at the next meeting of this Committee.

RESOLVED: That

(1)       the fact that there are no items for pre-scrutiny within the Key Decision Forward Plan for the period 1 June to 30 September 2011, which fall under the remit of this Committee, be noted;

(2)       the information regarding the final report of the Health Inequalities Working Group and progress on the implementation of its recommendations be received;

(3)       the appointment of the Chair and the two Party Spokespersons to the Joint Health and Well-Being Scrutiny Committee be noted, and they be requested to report back on meetings of that Committee, as and when they occur;

(4)       the various health providers who attended this meeting be invited to consider possible site visits during 2011/12, for Committee Members; and

(5)       possible topics for the establishment of working groups for 2011/12 be considered at the next meeting of this Committee.

The Chair reported that the former Strategic Director and the Head of Central Services, Social Care and Wellbeing Directorate, Sefton MBC, both regular attendees of this Committee, had recently retired and paid tribute to them both.

RESOLVED:

That thanks for all the support offered to this Committee and its Members be accorded to Charlie Barker and Bob McConnell and they both be wished the very best of luck for the future.