Agenda and minutes

Geoffrey Smith OBE, Healthwatch Representative

For minute 9:-

Mr E F White CC, Cabinet Lead Member for Health

Jane Chapman, Chief Strategy and Planning Officer, East Leicestershire and Rutland Clinical Commissioning Group (CCG)

Tim Sacks, Chief Operating Officer, East Leicestershire and Rutland CCG

Angela Bright, Chief Operating Officer, West Leicestershire CCG

Tony Menzies, Project Manager, West Leicestershire CCG

Dr Saurabh Johri, NHS 111 Clinical Lead

Jane Taylor, Leicester, Leicestershire and Rutland Emergency Care Director

John Adler, Chief Executive, University Hospitals of Leicester (UHL)

Dr Catherine Free, Emergency Care Medical Lead, UHL

Rachel Griffiths, Project Director, Site Reconfiguration, UHL

Mark Wightman, Director of Communications and Marketing, UHL.

To note that Dr S Hill CC was appointed Chairman of the Health Overview and Scrutiny Committee at the County Council meeting held on 26 June 2013.

RESOLVED:

That it be noted that Dr S Hill CC has been appointed Chairman of the Health Overview and Scrutiny Committee for the period ending with the Annual Meeting of the County Council in 2014.

Mr S J Hampson CC was nominated Deputy Chairman elect at the meeting of the County Council held on 26 June 2013.

RESOLVED:

That Mr S J Hampson CC be elected Deputy Chairman of the Health Overview and Scrutiny Committee for the period ending with the date of the Annual Meeting of the County Council in 2014.

The Chief Executive reported that no questions had been received under Standing Order 35.

The Chief Executive reported that no questions had been received under Standing Order 7(3) and 7(5).

There were no urgent items for consideration.

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting.

Dr T Eynon CC declared a personal interest in all items on the agenda as a salaried GP.

There were no declarations of the party whip.

The Committee considered a report and presentation of the local NHS which set out NHS plans for improving emergency care in Leicestershire, with particular regard to arrangements for Winter 2013.  A copy of the report and presentation marked ‘Agenda Item 9’ is filed with these minutes.

The Chairman welcomed the following NHS officers to the meeting:-

Jane Chapman, Chief Strategy and Planning Officer, East Leicestershire and Rutland Clinical Commissioning Group (CCG)

Tim Sacks, Chief Operating Officer, East Leicestershire and Rutland CCG

Angela Bright, Chief Operating Officer, West Leicestershire CCG

Tony Menzies, Project Manager, West Leicestershire CCG

Dr Saurabh Johri, NHS 111 Clinical Lead

Jane Taylor, Leicester, Leicestershire and Rutland Emergency Care Director

John Adler, Chief Executive, University Hospitals of Leicester (UHL)

Dr Catherine Free, Emergency Care Medical Lead, UHL

Rachel Griffiths, Project Director, Site Reconfiguration, UHL

Mark Wightman, Director of Communications and Marketing, UHL.

Arising from discussion the following points were raised:-

Improving Emergency Care

(i)      Concern was expressed that performance in meeting the target of treating 95% of patients accessing emergency care within four hours was not consistent.  It was acknowledged that performance varied on a daily basis and that the aim was to address this inconsistency.  Over the last few weeks a number of actions had been put in place to improve performance.  These actions were starting to have a positive impact on performance, which had been recorded last week as 92.9%.  It would take time for some of the actions to have an effect.  The Committee felt that this was an area which could usefully be revisited at its next meeting in order to consider progress.

(ii)     Actions being taken to improve performance included the following:-

·         Establishment of a command and control centre;

·         Engagement of staff at senior level;

·         Senior consultants’ shifts extended to midnight seven days a week;

·         Increasing assessment beds by 15 to 72;

·         Reassessing the mix of planned care and emergency care beds;

·         Getting the right skill mix amongst staff.

(iii)    The new single point of access for the Emergency Department had resulted in 30% of patients being redirected to the Urgent Care Centre.  However, the impact of this change on performance had been reduced because the patients still using the Emergency Department were the most complex and ill patients.

(iv)    Senior Emergency Department consultants met four times a day to monitor performance and consider deployment of staffing resources.  The commissioners reviewed performance on a daily basis.  Performance could also be reviewed by Emergency Department operational staff using the command and control centre.  This was an information hub which enabled staff to look at trends, variations and escalations in activity.  It was acknowledged that there were problems with the timeliness of information received from wards and discharge but, without moving to electronic patient records, there was no immediate solution to this.  Overall, it was felt that the new system was an improvement.

(v)     With regard to discharging patients, it was noted that the information required by the County Council’s Customer Service Centre was similar to that required by the CCGs.  It was suggested that a common template for data collection should be developed and used across health and social care.  The Committee was advised that work was ongoing to develop a single assessment process across health and social care.  To ensure that this happened, it would need to be treated as a project rather than being added to workloads.

(vi)    It was noted that the Secretary of State had allocated £10 million to UHL for Winter 2013 and that additional match funding would be provided by the CCGs.  Members welcomed this but  ...  view the full minutes text for item 9.

The Chairman sought and obtained the consent of the Committee to vary the order of business from that set out on the agenda.

The Committee considered a report of the Director of Adults and Communities which provided an update on the strategic review of adult preventative mental health services in Leicestershire and the implementation of the proposed service re-design to the Voluntary Service Officers Service and invited comments on the proposed commissioning option for the Adult Mental Health Social Drop In and Befriending Services.  A copy of the report marked ‘Agenda Item 11’ is filed with these minutes.

Healthwatch had submitted written comments on this item, a copy of which is filed with these minutes.

Arising from discussion the following points were raised:-

(i)      Officers from the Adults and Communities Department had attended social drop in clinics as part of the consultation process and had engaged with members of the black and minority ethnic (BME) community who had indicated that they would prefer a more inclusive service, not least because it could help with developing English language skills.  The proposal to make social drop in services more inclusive was therefore welcomed by the Committee.

(ii)     Members commented that often people attending self-help groups did not move on and suggested that encouraging service users to become more involved with the local community should be a requirement of the new service.  However, it was acknowledged that for some people, moving on was not possible.  Members welcomed the proposed flexibility of the new process which would both support people to access universal services and move on and would encourage the establishment of peer support groups and the setting of informal goals for service users who were not able to do so.

(iii)    It was noted that referral pathways into the social drop in and befriending service had not been robust and the intention to improve access was welcomed as were the intentions to improve performance monitoring.

RESOLVED:

That the comments now made be submitted to the Cabinet for consideration.

The Committee considered a report of the Chief Executive which provided an update on the current position with regard to the national review of children’s congenital heart services and advised of the role that the Committee could have in the new process.  A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.

Healthwatch had submitted written comments on this item, a copy of which is filed with these minutes.

Since the report had been written, NHS England had met with the Centre for Public Scrutiny (CfPS) to discuss the role of Local Government in the new review.  CfPS had advised that engagement with Local Government should not be limited to Overview and Scrutiny Committees.

NHS England had written to Councillor Cooke, who had chaired the Leicestershire, Leicester and Rutland Health Overview and Scrutiny Committee meeting which had referred the previous review to the Secretary of State, asking how he wished to be involved in the new review.  The Committee would be advised of his response.

RESOLVED:

(a)       That the report and information now provided be noted;

(b)       That officers be requested to update the Committee of any relevant developments during the review process.

The Committee considered a report of the Chief Executive which sought approval of the protocol between the Health and Wellbeing Board, Health Overview and Scrutiny Committee and Healthwatch Leicestershire.  A copy of the report marked ‘Agenda Item 12’ is filed with these minutes.

Healthwatch had submitted written comments on this item, a copy of which is filed with these minutes.

It was reported that the Health and Wellbeing Board had approved an amendment to the protocol at its meeting on 5 September to recognise that Healthwatch were participating observers of the Clinical Commissioning Group Board meetings.

RESOLVED:

That the protocol, as amended by the Health and Wellbeing Board on 5 September, be approved.

The next meeting of the Committee is scheduled to take place on 27^th November at 2.00pm.

It was noted that the next meeting of the Committee would be held on Wednesday 12 September at 4.00pm.