Agenda for Overview and Scrutiny Committee (Adult Social Care and Health) on Tuesday 3rd September, 2019, 6.30 pm

Agenda and minutes

Venue: Birkdale Room - Southport Town Hall, Lord Street, Southport, PR8 1DA. View directions

Contact: Debbie Campbell,  Senior Democratic Services Officer

Items
No. Item

12.

Introductions

Minutes:

The Chair welcomed everyone to the meeting and introductions took place.

 

13.

Apologies for Absence

Minutes:

Apologies for absence were received from Councillor Irving and his Substitute Councillor O’Hanlon; Councillor Myers and his Substitute Councillor Tweed; Councillor Pugh; and Councillor Moncur, Cabinet Member – Health and Wellbeing.

 

14.

Declarations of Interest

Members are requested at a meeting where a disclosable pecuniary interest or personal interest arises, which is not already included in their Register of Members' Interests, todeclare any interests that relate to an item on the agenda.

 

Where a Member discloses a Disclosable Pecuniary Interest, he/she must withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest, except where he/she is permitted to remain as a result of a grant of a dispensation.

 

Where a Member discloses a personal interest he/she must seek advice from the Monitoring Officer or staff member representing the Monitoring Officer to determine whether the Member should withdraw from the meeting room, including from the public gallery, during the whole consideration of any item of business in which he/she has an interest or whether the Member can remain in the meeting or remain in the meeting and vote on the relevant decision.

 

Minutes:

In accordance with Paragraph 9 of the Council’s Code of Conduct, the following declarations of personal interest were made and the Members concerned remained in the room during the consideration of the item:

 

Member

Minute No.

Nature of Interest

 

Councillor Roscoe

 

Minute No. 18 - Sefton Clinical Commissioning Groups – Update Report

 

She is an Administration and Support Officer for the British Lung Foundation;

 

Councillor

Carr

 

Minute No. 18 - Sefton Clinical Commissioning Groups – Update Report

 

His wife is employed by Aintree University NHS Foundation Trust.

 

 

15.

Minutes of the Previous Meeting pdf icon PDF 127 KB

Minutes of the meeting held on 25 June 2019.

Minutes:

 

RESOLVED:

 

That the Minutes of the meeting held on 25 June 2019, be confirmed as a correct record.

 

16.

Matters Arising from the Minutes - Public Health Annual Report

Minutes:

An update on data results and continuing work with schools was requested, in relation to air quality in Sefton.

 

RESOLVED:

 

That the Director of Public Health be requested to provide an update on the measuring and monitoring of air quality, together with details of the continuing work with schools, to the Senior Democratic Services Officer for circulation to Members of the Committee.

 

17.

Southport and Ormskirk Hospital NHS Trust pdf icon PDF 103 KB

Therese Patten, Deputy Chief Executive, to attend to give a presentation.

Additional documents:

Minutes:

The Committee considered the report submitted by Southport and Ormskirk Hospital NHS Trust that outlined the Acute Sustainability Programme. The report outlined the five models of care for specific services; the Fragile Service Review; analytic and engagement support and set out a conclusion.

 

Therese Patten, Deputy Chief Executive, and Terry Hankin, Medical Director, Southport and Ormskirk Hospital NHS Trust, were in attendance to report on recent developments at the Trust and to give a presentation to the Committee.

 

The presentation outlined the following:-

 

·         Southport and Ormskirk Hospital NHS Trust, by numbers;

·         History of the organisation in local headlines;

·         The Trust in context;

·         The Vision 2020: a safer, calmer Trust;

·         Quality priorities: Responsive to patients’ needs;

·         Improvement work streams;

·         Targeted investments;

·         Acute sustainability;

·         The Roadmap for the Acute Sustainability programme to enable the transition from current state, to interim to future state;

·         The workforce;

·         Safety and quality – improvement;

·         Planning for the future; and

·         Requests for questions and feedback.

 

Members of the Committee asked questions/raised matters on the following issues:-

 

·         Discussion took place regarding how to convey the improved mortality rates at the Trust to the public. This included referral of patients to the appropriate pathway.

 

·         Clarification was sought and provided regarding the five domains that formed the inspection framework adopted by the Care Quality Commission (CQC). Trust representatives did not consider that a “good” rating would be achieved at the next CQC inspection, although a number of improvements had been achieved.

 

·         The use and validity of the Friends and Family Test was queried and whether it captured the complete patient/family picture.

Complaints provided useful feedback and were utilised to provide improvements. The Friends and Family Test was part of a national mandatory process. A session on the CQC inspection framework and processes could be provided for Members of the Committee by the Sefton Clinical Commissioning Groups, if required.

 

·         How was A&E performing at the Trust?

A&E was performing well compared to regional comparators. As at March 2019, performance was at 88.7% for 4 hour waits, slightly below the quality target of 90%.

 

·         Would the provision of a walk-in centre in Southport affect A&E?

A&E at the Trust was considerably improved. Commissioners considered that budgets were not necessarily best spent on the provision of a walk-in centre in Southport, rather investment had taken place in frail elderly care and close joined-up integrated working took place with the Council’s Adult Social Care Team.

 

·         Issues had arisen with the recording of information on Transient Ischaemic Attack (TIA) (mini stroke). Was IT at the Trust adequate for sufficient data collection?

IT at the Trust was more than adequate and data recorded was over-sufficient. The TIA issue had recently been resolved. A different approach for the Friends and Family Test had just been procured by the Trust, with plans to roll-out the different approach in due course.

 

·         The imminent departure from the Trust of the Chief Executive was cause for concern amongst Members of the Committee, as he had brought  ...  view the full minutes text for item 17.

18.

Sefton Clinical Commissioning Groups - Update Report pdf icon PDF 180 KB

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

Minutes:

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: -

 

·         CCGs make good progress in annual assessment;

·         Governing Body welcomes Alan as its newest member;

·         New pilot stoma prescribing service to improve patient care;

·         Trans Health Sefton wins national award;

·         Sefton Health and Care Transformation Programme;

·         One to One (North West) Limited;

·         Aintree and Royal Hospitals coming together;

·         Health and wellbeing marketplace at “Big Chat meets Annual Review” event; and

·         Next governing body meetings.

 

Fiona Taylor, Chief Officer for NHS South Sefton CCG and NHS Southport and Formby CCG, was in attendance to present the update report to the Committee, to highlight particular aspects of it, and to respond to questions put by Members of the Committee.

 

Further to Minute No. 5 (2) of 25 June 2019, Mrs. Taylor reported verbally on the information requested previously on the seven day GP extended access scheme. A written briefing would be provided to Members of the Committee in due course.

 

Mrs. Taylor also indicated that hyper acute stroke services and details of the case for change for provision in South Sefton would be set out within the update report submitted to the next meeting of the Committee.

 

Members of the Committee asked questions/raised matters on the following issues: -

 

·         Could things have been done differently regarding the cessation of services by One to One (North West) Limited, the independent midwifery provider?

It had been known that the provider was experiencing financial difficulties since the beginning of the current financial year. Immediate action had been taken to transfer women to alternative providers once it was known that the provider was unable to continue operating. A review would be undertaken of events and any lessons learnt would be reported back to the Committee.

 

·         The findings of the staff engagement regarding the merger of Aintree and the Royal Hospitals had only recently been confirmed.

The Competitions and Markets Authority (CMA) would make the decision as to whether the merger went ahead. At present, it was anticipated that the merger would proceed in October 2019.

 

·         What would the new Trust be called if the merger went ahead?

The Liverpool University Hospitals NHS Foundation Trust. The three sites involved, which included Broadgreen, would be known by their current names.

 

·         Both Sefton CCGs had retained their “requires improvement” rating during the recent NHS England’s annual Improvement and Assessment Framework (IAF) assessment measures for all CCGs against 58 performance indicators. Could this be explained?

The Sefton CCGs were required to make improvements, predominantly on the financial position. Although the CCGs ended 2018/19 with £1m surplus, they now needed to make some £27m savings across both CCGs by the end of 2020/21.

 

·         Could information regarding the funding formula for budgets allocated to CCGs be made available?

This would be provided.

 

RESOLVED:That

 

(1)       the joint update report  ...  view the full minutes text for item 18.

19.

Sefton Clinical Commissioning Groups - Health Provider Performance Dashboard pdf icon PDF 1 MB

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

Minutes:

The Committee considered the joint report of NHS South Sefton Clinical Commissioning Group and NHS Southport and Formby Clinical Commissioning Group (CCG), providing data on key performance areas, together with responses for the Friends and Family Test for both Southport and Ormskirk Hospital NHS Trust and Aintree University Hospital NHS Foundation Trust. Information on the monitoring of the new 7 day GP extended access scheme for both CCGs was also included within the data.

 

Members of the Committee asked questions/raised matters on the following issues: -

 

·         There appeared to be a number of nurse appointments as part of the seven day GP extended access scheme. Was this a cost saving? Clarification was also sought regarding how GP referrals could be achieved where nurse appointments were utilised.

The extended access service was not a substitute for the normal GP service. The nurse appointments were not provided to achieve cost savings, rather appointments reflected the availability of the workforce, and the different skills mix available at the extended access venues were able to meet the needs of the patients.

 

RESOLVED:

 

That the information on Health Provider Performance be noted.

 

20.

Cabinet Member Reports pdf icon PDF 72 KB

Report of the Chief Legal and Democratic Officer.

Additional documents:

Minutes:

The Committee considered the report of the Chief Legal and Democratic Officer submitting the most recent Update Reports from the Cabinet Member – Adult Social Care, and the Cabinet Member – Health and Wellbeing, whose portfolios fell within the remit of this Committee.

 

The Cabinet Member Update Report - Adult Social Care, attached to the report at Appendix A, outlined information on the following:-

 

·         Strategic Commissioning;

·         Residential and Nursing Care Sector;

·         Performance Highlights;

·         Social Work Practice and Personalisation;

·         Financial Update:

o   Revenue; and

o   Adult Social Care Capital.

 

Councillor Cummins, Cabinet Member – Adult Social Care, was in attendance to present his Update Report and highlight particular aspects of it.

 

The Cabinet Member Update Report – Health and Wellbeing, attached to the report at Appendix B, outlined developments on the following aspects of Public Health:-

 

·         0-19 Healthy Child Programme;

·         Health Checks;

·         Social Prescribing;

·         Seasonal Flu;

·         Community Infection Control;

·         Public Health Annual Report - Air Quality in Sefton;

·         Health and Wellbeing Strategy;

·         Southport Money Advice Group;

·         Suicide Update;

·         Place Based Social Action;

·         Recreational Running Pathway;

·         Aspiring Instructors Programme 2019;

·        Leisure Performance quarterly update and Litherland lighting:

o   Early Intervention and Prevention:

-      Active Sports

o   Health and Wellbeing Delivery:

-       MOVE IT;

-       Active Ageing;

-       Active Lifestyles GP Referral Programme;

-       NHS Health Checks;

-       Weight Management Offer;

-       Active Workforce;

-       Dunes Splash World;

-       Crosby Lakeside;

-       Meadows Leisure Centre and Library;

-       Litherland Sports Park;

-       Netherton Activity Centre;

-       Bootle Leisure Centre;

o   Budget Performance;

o   Future Developments; and

·         Sports Awards 2019 update.

 

Councillor Moncur, Cabinet Member – Health and Wellbeing, had submitted his apologies for the meeting.

 

Members of the Committee asked questions/raised matters on the following issues: -

 

  • Reference was made to the newly established Forum that had been set up by a provider, in relation to the Residential and Nursing Care Sector. Concerns were held regarding future commissioning intentions by the Council if it was seen to be seeking advice from providers.

The purpose of the Forum was about close working with providers and to focus on quality end of life care. It was hoped that the Council, together with other providers, could learn from the provider who had received a rating of “outstanding” from the Care Quality Commission.

 

·         How many members did the Forum have?

Some 125 attendees were anticipated.

 

·         Could cameras be provided at care homes to assist staff when visitors arrived at the entrance?

The Council had no control over facilities provided at care homes. There were methods that could be adopted by care homes, such as key pads with numbers provided to relatives, in order to maintain contact by staff with care home residents.

 

·         Clarification was sought regarding the move by the Council from paying net to paying gross, in relation to the Residential and Nursing Care Sector.

Sefton’s current contractual arrangement was to pay providers the local authority contribution only; net of the client’s personal financial contribution toward their assessed care needs and any agreed third-party top-up  ...  view the full minutes text for item 20.

21.

Work Programme Key Decision Forward Plan pdf icon PDF 76 KB

Report of the Chief Legal and Democratic Officer.

Additional documents:

Minutes:

The Committee considered the report of the Chief Legal and Democratic Officer, seeking the views of the Committee on the draft Work Programme for the remainder of the Municipal Year 2019/20; and identifying any items for pre-scrutiny scrutiny by the Committee from the Key Decision Forward Plan.

 

A Work Programme for 2019/20 was set out at Appendix A to the report, to be considered, along with any additional items to be included and agreed.

 

The Chief Officer for NHS South Sefton Clinical Commissioning Group (CCG) and NHS Southport and Formby CCG indicated that an item on Primary Care Networks (PCNs) could be submitted to the Committee during January or February 2020 and the Leads for the PCNs could be invited.

 

Members of the Committee raised matters on the following issues:-

 

·         Social prescribing and a more tailored approach to issues within individual Wards.

 

·         Community Substance Use

 

There were six Decisions within the latest Key Decision Forward Plan, attached to the report at Appendix B, that fell under this Committee’s remit, and the Committee was invited to consider items for pre-scrutiny.

 

RESOLVED: That

 

(1)       the Work Programme for 2019/20, as set out in Appendix A to the report, be agreed;

 

(2)       the following additional items be added to the Committee’s Work Programme for 2019/20:-

 

(a)        the Chief Officer for NHS South Sefton Clinical Commissioning Group (CCG) and NHS Southport and Formby CCG be requested to submit an item on Primary Care Networks to the meeting of the Committee either on 7 January 2020 or 25 February 2020;

 

(b)        the Chief Officer for NHS South Sefton Clinical Commissioning Group (CCG) and NHS Southport and Formby CCG be requested to submit an item on Public Health Prescribing to the meeting of the Committee either on 7 January 2020 or 25 February 2020;

 

(c)        the Chief Officer for NHS South Sefton Clinical Commissioning Group (CCG) and NHS Southport and Formby CCG be requested to submit an item on social prescribing to the meeting of the Committee either on 7 January 2020 or 25 February 2020;

 

(d)        the Head of Health and Wellbeing be requested to submit an item on Community Substance Use to the meeting of the Committee either on 7 January 2020 or 25 February 2020; and

 

(3)       the contents of the Key Decision Forward Plan for the period 1 September – 31 December 2019, be noted.