Agenda and minutes

An apology for absence was received from Councillor Lappin.

The following declarations of personal interest were received:-

Minutes of the meeting held on 6 January 2015.

Further to Minute No. 32 of 21 October 2014, a Member of the Committee asked whether any further information had been received from NHS England.

The Chair reported that she had been advised by NHS England that activity had been taking place on the issues raised by this Committee.

RESOLVED: That

(1)       the Minutes of the meeting held on 6 January 2015, be confirmed as a correct record; and

(2)       NHS England be requested to provide information on the issues raised by this Committee prior to the next meeting.

Update Report submitted by Aintree University Hospital NHS Foundation Trust.

The Committee considered an update report submitted by the Director of Communications, Aintree University Hospital NHS Foundation Trust, on developments at the Trust. The report outlined details of the following:-

·         Service news: Winter developments;

·         New A&E psychological support service to start;

·         Urgent Care and Trauma Centre opening in less than 100 days;

·         Nursing recruitment;

·         Aintree teams up with British Red Cross to support elderly patients when they leave hospital; and

·         Aintree supports ‘Hello my name is …’ campaign.

Fin McNicol, Director of Communications, Aintree University Hospital NHS Foundation Trust,was present from the Trust to present the update report to the Committee and respond to questions put by Members.

A Member of the Committee referred to the recent winter pressures placed on Accident and Emergency services and asked whether the Trust had experienced any particular difficulties with social care not being in place for patients ready for discharge from hospital.

The Director of Communications responded that the Trust discharged patients to three separate Council areas and although discussions on social care were on-going, he was not aware of any particular difficulties with the Sefton area.

RESOLVED:

That the update report submitted by the Aintree University Hospital NHS Foundation Trust be received and the Trust be thanked for the update report.

Joint update report of NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group.

The Committee considered the joint update report of the NHS South Sefton Clinical Commissioning Group and the NHS Southport and Formby Clinical Commissioning Group (CCG) providing an update about the work of the CCGs. The report outlined details of the following:-

·         Shaping Sefton – new models of care;

·         Decision on Out of Hours Pharmacy; and

·         Update on breast care services for Southport and Formby patients.

Martin McDowell, Deputy Chief Officer and Chief Finance Officer, and Jan Leonard, Chief Commissioning and Redesign Officer, NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group, were present from the CCGs to present the update report to the Committee and respond to questions put by Members of the Committee.

A Member of the Committee asked about numbers of patients affected by the recent cessation of breast care services at Southport and Ormskirk Hospital NHS Trust and was advised that prior to the service closing around 40 patients per week from across Southport, Formby and West Lancashire chose to be referred to the service. Less than 10% of these cases were diagnosed with cancer.  Around 1000 patients remained in the care of Southport and Ormskirk Hospital since its service closed to new patients.

RESOLVED:

That the joint update report submitted by the Clinical Commissioning Groups be received and the CCGs be thanked for the update report.

Report of the Director of Public Health.

The Committee considered the report of the Director of Public Health on the 2014 Public Health Annual Report that focused on a key issue, reviewing progress and highlighting future challenges. The production of an annual report, highlighting the health of the local population, was a legal requirement by the Director of Public Health.The 2014 Public Health Annual Report, focused on one of the key objectives of the Joint Health and Wellbeing Strategy, that of giving every child the best possible start in life.

The report included chapters relating to key areas, namely health needs in Sefton; Sefton as a place to thrive; school readiness: getting the best start in education; pregnancy in Sefton; emotional wellbeing; protecting mothers and babies: antenatal and newborn screening; health visiting and family nurse partnership; healthy lifestyle choices; and keeping children safe.

Two additional Appendices to the Public Health Annual Report were circulated for consideration by the Committee.

Dr. Janet Atherton, Director of Public Health, explained that the Public Health Annual Report was currently in draft form in order that any amendments made could be incorporated into the final version.

Dr. Atherton gave a presentation on the Public Health Annual Report 2014. The presentation outlined the following:-

Overview

·         Focus on 0-5s:

o   Giving children the best start in life;

o   Commissioning of Healthy Child Programme for   0-5s becomes council responsibility from October 2015; and

·         Comprehensive overview of Public Health (PH) Outcomes Framework and Child Health Profile.

Since 2002:

·         Three years longer life expectancy;

·         Heart disease death rates halved;

·         Teenage pregnancy rates at their lowest;

·         Immunisation rates at their highest;

BUT

·         Inequalities need a sustained concerted focus.

Overview of report:

·         Health outcomes – focussing on children 0-5;

·         Sefton as a place to thrive;

·         School readiness;

·         Pregnancy;

·         Emotional wellbeing;

·         Protecting mothers and babies - screening and immunisation;

·         Healthy lifestyle choices – smoking in pregnancy and breastfeeding;

·         Keeping children safe; and

·         Overview of PH Outcomes Framework and Child Health Profile.

Key messages:

·         Healthy start critical to health throughout life;

·         Children need healthy families, communities and places to thrive;

·         Healthy Child Programme – universal services with additional support for those who need it; and

·         National policy important – poverty, food, physical activity.

The Chair queried whether the Annual Report should be submitted to the Overview and Scrutiny Committee (Children's Services), in view of the focus on 0-5 years of age.

A Member of the Committee referred to the fact that this was the final Public Health Annual Report produced by Dr. Atherton and congratulated her on the work she had achieved during her time as Director of Public Health.

The issue of health inequalities was also raised and Dr. Atherton indicated that although this issue featured the wider determinants, preventative work and much of the work undertaken by the Clinical Commissioning Groups had achieved a great deal.

RESOLVED  That

(1)       the Public Health Annual Report 2014 be received; and

(2)       the Director of Public Health be requested to submit the draft Public Health Annual Report 2014 to the Chair  ...  view the full minutes text for item 60.

Report of the Director of Older People.

The Committee considered the report of the Director of Older People updating the Committee on the required changes associated with the Care Act 2014 and the progress towards implementation. The report outlined the background to the matter; arrangements for the implementation of the Act; focus on assessment and eligibility; changes and new duties effective from April 2016; risks and challenges; policy change, communication, consultation and engagement; the Equality Act 2010 duty and impact assessments; together with conclusions.

Two handouts on Eligibility and Carers’ Eligibility were circulated for information.

Dwayne Johnson, Director of Older People, gave a presentation on The Care Act 2014. The presentation outlined the following:-

·         Overview;

·         The Care Act 2014 replaces many previous laws;

·         What will change from 2015?;

·         What will change from 2016?;

·         The constant balancing act of continuation of delivery against the impact of new legislation;

·         Wellbeing and Prevention;

·         Assessment and Eligibility;

·         Charging and Financial Assessment;

·         Information and Advice;

·         Carers Services;

·         Safeguarding;

·         New Burdens Funding;

·         Sefton Progress;

·         Workforce Development;

·         Risks;

·         Focus on Assessment and Eligibility;

·         Considerations if individuals have needs caused by physical or mental impairment or illness;

·         ‘Being unable to achieve’specified outcomes includes certain circumstances; and

·         The Wellbeing Principle.

The Committee broke out to consider, in pairs, one of four different case studies and after due consideration, reported back on findings on each of the case studies.

Members of the Committee raised the following points:-

·         whether there was an appeals process against the outcome of findings by the Council;

·         decisions taken by hospital staff in relation to discharge arrangements for patients; and

·         the number of cases anticipated when the Act came into force.

The responses made were as follows:-

·         an appeals process was being considered as part of an on-going review of the Act and its implementation;

·         discharge planning agreements existed which set out clear guidelines on patient discharge from hospital. In addition, regular meetings took place to minimise any instances of patient discharge without reference to the local authority, where it was required; and

·         the number of cases anticipated was estimated on the Lincolnshire model and would be revised as the Act was implemented. The last census had revealed a high number of carers in some capacity.

RESOLVED:          That

(1)       the content of the report be noted;

(2)       further updates be received; and

(3)       on-going work to implement the Act in Sefton be scrutinised.

Report of the Director of Corporate Services.

The Committee considered the report of the Director of Corporate Services submitting the most recent report by the Cabinet Member - Older People and Health for the period January – February 2015. The Cabinet Member Update Report outlined information on:-

Adult Social Care:

·         LGC Awards 2015;

·         Remodelling Day Opportunities;

·         Care Act, including:

o   Advocacy;

o   Deferred payments;

o   Eligibility;

o   Assessment;

o   Funding allocations;

o   Workforce development; and

o   Carers.

Public Health:

·         Substance Misuse – Adult Treatment and Recovery Service (Lifeline);

·         0-5 Transition update January 2015; and

·         Flu.

Councillor Cummins, Cabinet Member – Older People and Health, was present at the meeting and outlined the main issues within the Update Report.

Members of the Committee raised the following issues:-

·         whether there was a market to meet needs associated with day opportunities;

·         whether day opportunities would be increased; and

·         take-up of flu vaccinations in under 65s and effectiveness of the vaccine.

The responses made were as follows:-

·         re-modelling of day opportunities would be a two year programme and a whole range of different initiatives and approaches was being considered to meet individual needs;

·         day opportunities were likely to be increased as demographics indicated that there was increased demand. This would not be achieved purely through day care centres; and

·         whilst take-up of flu vaccinations had been good amongst the over 65s, take-up amongst those at risk in the under 65 age category could be improved. This matter lay with NHS England which was considering plans for next winter. The vaccination relied on predictive strains which had not been fully accurate this winter, although the advice was still to immunise as rates of flu this winter had been higher than the previous two years.

RESOLVED:

That the Cabinet Member report be received.

Report of the Director of Corporate Services.

The Committee considered the report of the Director of Corporate Services submitting the latest information regarding the monitoring of Accident and Emergency Services. The report set out the background to the matter and attached recent information provided on local Accident and Emergency Services performance by the Merseyside Area Team. The information illustrated the latest weekly performance, including the year to date performance, against requirements to deliver at 95%.

The Committee was invited to consider the information provided on Accident and Emergency Services, in relation to the Aintree University Hospital NHS Foundation Trust and the Southport and Ormskirk Hospitals NHS Trust, and comment, as appropriate.

The Senior Democratic Services Officer indicated that there was a recommendation relating to the continuation of these reports under Minute No. 64, the Work Programme Key Decision Forward Plan, below.

RESOLVED:

That the information regarding monitoring of Accident and Emergency Services be received.

Report of the Director of Corporate Services.

The Committee considered the report of the Director of Corporate Services submitting the latest Key Decision Forward Plan and seeking the views of the Committee on its Work Programme for the remainder of the Council Year 2014/15.

There were two items within the current Key Decision Forward Plan which fell under the remit of the Committee, on this occasion.

The work programme of items submitted to the Committee during 2014/15 was attached to the report, at Appendix B.

The report outlined recent activity with regard to Joint Working Protocols; the Joint Health Scrutiny Committee for Cheshire and Merseyside; the Joint Health Scrutiny Committee for Sefton and St. Helens and site visits.

The report also set out proposals regarding the process to be undertaken for the scrutiny of draft Quality Accounts during 2015, together with a number of proposals arising from an informal meeting of Members of the Committee that would impact on the work programme for the Committee during 2015/16.

The Senior Democratic Services Officer drew Members' attention to the recommendation within the report relating to Southport and Ormskirk Hospital NHS Trust and Aintree University Hospital NHS Foundation Trust. She also sought clarification relating to the process to be undertaken for the scrutiny of the draft Quality Accounts during 2015 and the continuation of the Accident and Emergency Monitoring reports.

The Chair reported on progress with regard to the Joint Health Scrutiny Committee for Sefton and St. Helens.

RESOLVED: That

(1)       the contents of the Key Decision Forward Plan for the period 1 March – 30 June 2015 be accepted;

(2)       the fact that the Joint Working Protocol between this Committee and the Health and Wellbeing Board has now been approved be noted;

(3)       the following recommendations of the Joint Health Scrutiny Committee, regarding cancer services for Cheshire and Merseyside be supported:

(a)       the decision of the Joint Committee to support the proposed future model of cancer services for Cheshire and Merseyside, including the new site adjacent to the Royal Liverpool University Teaching Hospital be noted; and

(b)       the recommendation that a discretionary Joint Scrutiny Committee to oversee the delivery of the new build project in Liverpool and refurbishment of the Wirral site is retained to maintain a scrutiny and oversight role during the lifetime of the project be supported;

(4)       progress to date with regard to the Joint Health Scrutiny Committee for Sefton and St. Helens be noted;

(5)       the work programme of items for 2014/15 be received;

(6)       the recent site visit to The Walton Centre NHS Foundation Trust be noted and the forthcoming site visit to Ormskirk Hospital be supported;

(7)       the process to be undertaken for the scrutiny of draft Quality Accounts in 2015 be approved, namely:

(a)       an informal daytime meeting of Committee Members be held on a date to be determined by the Chair of the Committee, at Formby Professional Development Centre, on a date between the Elections to be held on 7 May and the Annual Meeting of the Council;

(b)       the Chief  ...  view the full minutes text for item 64.