Agenda and minutes

Apologies for absence were received from Councillor Pearson and his Substitute, Councillor Ibbs; Diane Blair, Acting Manager, Sefton LINk Support; and Fin McNicol, Director of Communications, Aintree University Hospitals Foundation Trust.

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:-

 

Member	Minute No.	Reason	Action
Councillor Hill	No. 76 – NHS Sefton – Update Report	Personal – his wife is employed by Southport and Ormskirk Hospital NHS Trust	Took part in consideration of the item and voted thereon.

 

Minutes of the meeting held on 14th December 2010.

RESOLVED:

 

That, subject to the inclusion of Councillor McGuire in the apologies for absence, the Minutes of the meeting held on 14^th December 2010, be confirmed as a correct record.

Presentation to be made by Janet Atherton, Acting Chief Executive, NHS Sefton.

The Committee received a presentation by Janet Atherton, Acting Chief Executive, NHS Sefton on Improving Children’s Services in North Sefton.

 

The presentation included the following:-

 

Purpose:-

·        Feedback on additional work undertaken to review options for improving access to children’s services;

·        Report progress on development of services; and

·        Seek views on options for improving access to services for children with minor injury.

 

Project:-

·        To identify improvements that could be made in short term while work on sustainable model for children’s services and urgent care undertaken through North Mersey QIPP programme;

·        Oversight group;

·        Clinical design group;

·        Health status review;

·        Activity data review;

·        Engagement with children and families; and

·        Clinical engagement.

 

Strategic Context:-

·        Children’s health is one of the strategic priorities;

·        Care closer to home where appropriate and cost-effective;

·        Strategic plan and Sefton children’s services review priorities:

- Children with long term conditions;

- Children with complex needs ;

·        NHS Operating Framework 2011/12:

- Children with disability;

- CAMHS;

- Looked After Children;

- Family Nurse Partnerships;

·        N Mersey QIPP:

- £300m efficiency savings needed;

- Urgent Care and Children’s work-streams identifying most cost-effective models of care; and

·        Knock on impact of other public sector cuts.

 

Data:-

·        20,800 children aged 0 - 16 in Southport and Formby;

·        10-19 year age group projected to fall by 20% over next five years, 0-10s steady;

·        Increasing numbers of children with complex needs;

·        4866 children attend A&E with minor conditions (13 per day); and

·        Average child will attend A&E with minor condition once every 4 years.

 

Public Engagement:-

·        Better integration of services;

·        Build on good access to primary care;

·        More out patient services in Southport and better signage in Ormskirk; and

·        Care in right place, first time – better publicity of services available.

 

Clinical Engagement:-

·        Recognise need to improve services especially for LTCs and disability;

·        Minor illness predominantly treated in primary care – best place;

·        Extent to which GPs deal with minor injury depends on experience and time – difficulties maintaining skills as low numbers seen; and

·        Support for telephone advice from Consultant paediatricians.

 

Service Developments:-

·        Creation of a children’s hub at Southport Centre for Health and Wellbeing;

·        CAMHS;

·        Community paediatrics;

·        Out patient clinics for LTCs;

·        Dental;

·        Sexual health, etc; and

·        Voluntary sector.

 

Reducing Attendances for Minor Illnesses:-

·        Communications – Choose Well;

·        Improving access to general practice:

- Telephone access to GP;

- GP telephone access to Consultant for advice;

·        Children’s hub:

- Better management of LTCs results in reduced unplanned care episodes.

 

Options for Minor Injury Service:-

·        Stand alone walk in centre not considered feasible;

Alternative options:

·        Nurse led minor injury service;

·        GP based minor injury service;

·        Nurse led service in GP Out of Hours;

Assessed against criteria:

·        Clinical safety;

·        Workforce;

·        Clinical need; and

·        Financial viability.

 

Next Steps:-

·        Progress service developments;

·        Continue to work with North Mersey QIPP on urgent care and children’s services;

·        Views on options regarding minor injury from:

- Children’s Trust;

- Stakeholder Group;

- Overview and Scrutiny Committee;

-  ...  view the full minutes text for item 83.

Presentation to be made by Hannah Chellaswamy, Acting Director of Public Health, NHS Sefton and Sefton Council.

The Committee received a presentation by Hannah Chellaswamy, Acting Director of Public Health, NHS Sefton and Sefton Council, on the White Paper “Healthy Lives, Healthy People”, the Government’s strategy for public health in England.

 

The presentation included the following:-

 

A New Public Health System – Key principles:

•         A return of public health leadership to Local Government;

•         Professional leadership nationally and locally;

•         Dedicated resources for public health at national and local levels;

•         Focus on outcomes and evidence-based practice;

•         Maintaining a strong relationship with the NHS, social care and civil society; and

•         Enshrined in Health and Social Care Bill 2011 (Published 19 January 2011).

 

Health and Wellbeing Throughout Life:-

1. Empowering local government and communities;
2. Tackling health inequalities;
3. Coherent approach to different stages of life;
4. Giving every child the best start in life;
5. Making it pay to work;
6. Designing communities for active ageing and sustainability; and
7. Working collaboratively with business and voluntary sector –’Public Health Responsibility Deals’.

 

Public Health (PH) England - Operational in 2012/13:-

•         New public health service directly accountable to the Secretary of State for Health with a clear mission to:

1. Achieve measurable improvements in public health outcomes; and
2. Provide effective protection from threats to the public (will incorporate Health Protection Agency and National Treatment Agency).

•         It will do this by:

–        Protecting people from infectious disease and biological, chemical and radiological threats;

–        Helping people and families to be able to take care of their own health and wellbeing; and

–        Inspiring, challenging and commissioning partners from all sectors to work together.

 

Key Functions for Local Government:-

•         New statutory duty for local authorities to promote and improve health of population;

•         Joint Strategic Needs Assessment (JSNA) and joint health and wellbeing strategy with DASS, DCS, GP consortia leads and Health Watch;

•         Health & Wellbeing Boards – how public money is spent and outcomes achieved and how health inequalities are being addressed, but scrutiny role taken out;

•         NHS Complaints advocacy; and

•         Local government will be accountable to PH England.

 

Health and Wellbeing Board:-

•         One per Local Authority and will be a committee of the LA (Local Authority) under Section 102 of the Local Government Act;

•         Proposed Membership:

–        At least one councillor;

–        Director of Adult Social Services;

–        Director of Children’s Services;

–        Director of Public Health;

–        Local Health Watch (LINKs with a wider remit);

–        A representative from each relevant GP commissioning consortium; and

–        Any others – to be determined by the LA.

–        Duty to encourage integrated working; and

–        No longer will have scrutiny function.

 

The Director of Public Health and Team within the LA:-

•         Director of Public Health will be the principal adviser on all health matters on the full range of local authority functions and their impact on the health of the local population to:

–        the local authority and its elected Members and officers;

•         Jointly appointed by LA and PH England and employed by  ...  view the full minutes text for item 84.

Draft Protocol to be circulated.

Further to Minute No. 66(E) of 16^th November 2010, a draft protocol for working together, prepared jointly between officers of NHS Sefton and an Overview and Scrutiny Officer, Sefton MBC, for NHS Sefton and this Committee, was circulated for consideration by Members. The draft protocol set out proposed roles and responsibilities for both NHS Sefton and this Committee and also set out the following:-

 

• Which matters could be reviewed and scrutinised according to regulations;
• Substantial developments or variations (SDVs) in services;
• Factors to be taken into account in determining a SDV; and
• A process to be followed for highlighting a SDV.

 

The draft protocol would be presented to NHS Sefton’s Governance Committee and then the Trust Board, once it was agreed by this Committee.

 

RESOLVED: That

 

(1)       any comments, suggestions or amendments by Members be referred to the Overview and Scrutiny Officer for this Committee; for inclusion in the draft protocol, prior to the next meeting; and

 

(2)       that full consideration of the draft protocol be deferred to the next meeting of this 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. Information was provided on the following:-

 

A.        Welcome Back Paul

 

The Chair of NHS Sefton, Paul Acres, had been away since August 2010 due to ill health but had returned to duty at the commencement of 2011. Frances Street had carried out the role of Interim Chair in Paul’s absence and NHS Sefton was grateful for her hard work and commitment during that time. Frances had now been appointed Chairman of the new Community Health Trust in Wirral.

 

B.        Update on NHS Reforms

 

Following on from the White Paper for Health, “Equity and Excellence: Liberating the NHS”, key documents had been published at the end of 2010, paving the way for the reforms outlined.

 

The public consultation on the White Paper had produced some 6,000 responses and the Government had now produced its response to this consultation, including the extension of local authorities’ formal scrutiny powers to cover all NHS funded services, and giving them greater freedom in how these were exercised. GP consortia were now expected to be the commissioners of maternity services, rather than the NHS Commissioning Board, as the Government had originally intended.

 

The Operating Framework 2011-2012, had been published, setting out key actions to support NHS organisations during the transitional period. Detailed timescales for the transition were now provided, including the ‘clustering’ of primary care trusts by June 2011 and greater support for emerging GP consortia to ensure they were ready to take over their responsibilities in April 2013.

 

The first Outcomes Framework for the NHS had also been published, setting out 50 indicators in five key domains around patient safety and clinical quality.

 

C.        Have Your Say on NHS Reforms

 

A number of consultations associated with the planned reforms were currently taking place. Consultation documents could be viewed via the NHS Sefton web-site and views could be e-mailed to the same website prior to the following deadlines:-

 

• White paper for public health, ‘Healthy Lives, Healthy People’ – deadline 8^th March 2011;
• Public health outcomes framework – deadline 31^st March 2011;
• Funding and commissioning routes for Public Health – deadline 31^st March 2011; and
• Developing the NHS workforce – 31^st March 2011.

 

D.        Coping with Winter Pressures on the NHS

 

NHS organisations across the north west region had been working together to manage the additional pressures on health services caused by the colder weather and extended holiday period, during the winter months. People were being reminded to choose the right service for them when they were ill, whether it was free advice on minor illnesses from pharmacists, contact with NHS Direct, Accident and Emergency, 999 emergency telephone calls and GP teams.

 

E.        Are You Protected against Seasonal Flu?

 

Flu could be extremely serious for those with conditions like asthma, diabetes and heart disease, those over 65 years and pregnant women. There was still time for eligible Sefton residents  ...  view the full minutes text for item 86.

Report of the Strategic Director - Social Care and Well-Being.

Further to Minute No. 51 of the meeting of the Cabinet Member – Health and Social Care held on 19^th January 2011, the Committee considered the report of the Strategic Director - Social Care and Well-Being on the proposal to use the ICT Strategy Capital in conjunction with the Adult Social Care Infrastructure grant to support the implementation of a new Client Management Database.

 

The report indicated that capital funding was required to develop the IT infrastructure to:-

 

• improve information sharing between health and social services;
• improve the management records of vulnerable adults and streamline the financial systems;
• improve the statutory obligation to safeguard vulnerable adults throughout the Borough;
• support mobile and flexible working to reduce costs and improve service delivery; and
• improve and streamline management information to assist service planning and budget management.

 

The funding was predominantly aimed at transformation and was specifically aligned to changing the way the Council worked as an organisation and to build capacity for the future.

 

The Chair reported that although this was a Key Decision, it had not been included in the Forward Plan. Consequently, he had been consulted, under Rule 15 of the Access to Information Procedure Rules of the Council’s Constitution, on the decision being made by the Cabinet Member/Cabinet, on the basis that it had been impracticable to defer the decision until the commencement of the next Forward Plan, because of the urgency of the matter. The Chair considered that, given the circumstances, the issue ought to be considered by this Committee, as a matter of courtesy.

 

RESOLVED:

 

That the report be received.

Report of the Assistant Chief Executive.

The Committee considered the report of the Assistant Chief Executive in relation to the Committee’s programme of work. There was just one Decision within the latest Key Decision Forward Plan that fell under this Committee’s remit, and there were no new items on this occasion.

 

Work was continuing for the cross-cutting Working Group, comprised of the four Overview and Scrutiny Chairs plus two Labour Members, and a final report was being drafted.

 

A site visit for Members of this Committee to visit Southport and Formby District General Hospital premises on 14^th February 2011 had been arranged which would allow Committee Members the opportunity to meet members of the Hospital’s Trust Board and view recent developments, such as the refurbishment of the Accident and Emergency Department.

 

RESOLVED: That

 

(1)       the contents of the Key Decision Forward Plan for the period 1 February – 31 May 2011 be accepted;

 

(2)       the progress and actions of the cross-cutting Working Group, to scrutinise health inequalities within the Borough, be supported; and

 

(3)       the Committee visit to Southport and Formby District General Hospital premises in February 2011 be supported.