Meeting documents

It was proposed and duly seconded that Lin Hazell be elected Chairman of the Committee for the ensuing year.

RESOLVED

That Lin Hazell be elected Chairman of the Health and Adult Social Care Select Committee for the ensuing year.

The Chairman appointed County Councillor Roger Reed as Vice-Chairman of the Committee for the ensuing year.

RESOLVED

That Roger Reed be appointed as Vice-Chairman of the Health and Adult Social Care Select Committee for the ensuing year.

Roger Reed and Noel Brown have replaced Mark Shaw and Carl Etholen on the Select Committee.

Apologies were received from Noel Brown, Julia Wassell and Freda Roberts.

There were no declarations of interest.

of the meeting held on Tuesday 15 April 2014 to be confirmed as a correct record.

The minutes of the meeting held on Tuesday 15 April 2014 were agreed as a correct record.

Matters arising

p.6 The following data has been provided by Buckinghamshire Healthcare Trust in relation to the number of contacts through our adult community healthcare teams, which consist of district nurses and therapy staff. It covers the past three years and shows an increase year-on-year:

p.6 The questions relating to the Community Transport Hub are still outstanding.

p.11 The issue around the quality of discharge papers is still outstanding and it was agreed that James Povey, policy officer, would continue to chase this.

Action: James Povey

p.14 The Better Care Fund will be discussed at the June meeting.

This is an opportunity for members of the public to put a question or raise an issue of concern, related to health.   Where possible, the relevant organisation to which the question/issue is directed will be present to give a verbal response.  The member of public will be invited to speak for up to four minutes on their issue.  A maximum of 30 minutes is set aside for the Public Questions slot in total (including responses and any Committee discussion). This may be extended with the Chairman’s discretion. 

For full guidance on Public Questions, including how to register a request to speak during this slot, please follow this link:

http://www.buckscc.gov.uk/about-your-council/scrutiny/get-involved/

The following questions have been received in advance of the meeting.

Question from District Councillor Rachel Pope

"As a South Bucks District Councillor I remain very concerned with the poor quality of care and anxieties residents/some of my patients feel they receive from our local hospital – Heatherwood and Wexham.  What assurance can your scrutiny committee offer me to show they are committed to assessing and improving local hospital care for our South Bucks residents given that Heatherwood and Wexham are now in special measures".

Representatives from Heatherwood and Wexham Park Hospital will be attending the meeting.

Questions received from Bill Russell

Q1. Healthwatch Buckinghamshire

Could you please find out for me who is responsible at Bucks County Council for the performance management of HealthWatch Buckinghamshire?

I am concerned that:

a)    Healthwatch Buckinghamshire are not holding board meetings or any sort of meetings in public.

b)    They are not providing feedback to the public on their activities, e.g not reporting on how many people have contacted them with information about health and social care services.

c)    They have provided nay feedback to the public on what they are saying during their meetings with commissioners and providers and other organisations

d)    They are not providing any information about how the funds they have to achieve their role is being spent.

For a body that is meant to seek out the experiences of the public when using health and social care services they are remarkably secretive.  This is not a good example of best practice.

Q2. Health and Wellbeing Board

There is a an ambitious plan to combine £100 million form the Health and social care budgets to provide care for the elderly through the Better Care Fund.

There does not seem to have been any consultation or involvement with the public on this significant change to the way that services are provide?   Could you tell me why this is so?

The best outcomes for change programmes are achieved if all stakeholders (and that includes the population of Buckinghamshire) are involved early, in a meaningful way and in a sustained manner in the design process.   This has not occurred in this case.  Can you please raise this issue with those concerned?

I am in favour of the concept but I am concerned that the timescale is very short for such an  ...  view the full agenda text for item 4.

The following questions were received in advance of the meeting.

Question from District Councillor Rachel Pope

"As a South Bucks District Councillor I remain very concerned with the poor quality of care and anxieties residents/some of my patients feel they receive from our local hospital – Heatherwood and Wexham.  What assurance can your scrutiny committee offer me to show they are committed to assessing and improving local hospital care for our South Bucks residents given that Heatherwood and Wexham are now in special measures".

The Chairman explained that representatives from Heatherwood and Wexham Park Hospital and Frimley Park Hospital will be presenting an update to Members at this meeting.

Questions received from Bill Russell

Q1. Healthwatch Buckinghamshire

Could you please find out for me who is responsible at Bucks County Council for the performance management of HealthWatch Buckinghamshire?

I am concerned that:

a)    Healthwatch Buckinghamshire are not holding board meetings or any sort of meetings in public.

b)    They are not providing feedback to the public on their activities, e.g not reporting on how many people have contacted them with information about health and social care services.

c)    They have provided no feedback to the public on what they are saying during their meetings with commissioners and providers and other organisations

d)    They are not providing any information about how the funds they have to achieve their role is being spent.

For a body that is meant to seek out the experiences of the public when using health and social care services they are remarkably secretive.  This is not a good example of best practice.

The following written response was provided by Alex Care, Project Development Officer from Buckinghamshire County Council.

"I have already raised the issue of Healthwatch Bucks not holding its Board meetings in public (a statutory requirement). I am pleased to see that they have published the time and place of their next Board Meeting and I will be pressing them to begin publishing future meeting venues, times and agendas. Meeting notes and board reports have always been published on their website, but like you, I believe that the Board activity and deliberations should be made more transparent.

With respect to the other information that you would like Healthwatch Bucks to be publishing, much of it is on their website which has been developed throughout the year and does provide information to the public. In addition, their annual report will provide a comprehensive overview of their activity and deployment of resources over the year.

It’s helpful to be mindful that Healthwatch Bucks is a new organisation which has spent its first year setting itself up and building relationships with key stakeholders (as have many other Healthwatch organisations). In addition to this, Healthwatch Bucks has responded to the Keogh review and has been involved with developing a national performance management tool with Healthwatch England in recognition of some of the best practice work identified in our own contractual performance tool development."

Q2. Health and Wellbeing Board  ...  view the full minutes text for item 4.

For the Chairman of the Committee to provide an update to the Comment on recent scrutiny related activity.

The Chairman reported that the inquiry proposals have been circulated to Committee Members.  It was agreed to undertake an inquiry into primary care service provision of GPs followed by an inquiry around Adult Social Care services.

For Members of the Committee to provide any updates on health and social care topics or providers.

There was nothing to report under this item.

For Members to scrutinise actions being taken by Heatherwood and Wexham Park Hospitals NHS Foundation Trust to address recent quality and care concerns identified by the Care Quality Commission, and the proposed acquisition of the Trust by Frimley Park NHS Foundation Trust.

Contributors

Grant Macdonald – Acting Chief Executive Heatherwood and Wexham Park Hospitals NHS Foundation trust

Mr Edward Palfrey – Director of Clinical Integration, Frimley Park Acquisition Project Team

Papers

HWP Trust’s Response to the Findings of the Reports

Frimley Park acquisition of HWP Update – to follow

The Chairman welcomed Grant Macdonald, Acting Chief Executive, Heatherwood and Wexham Park Hospitals NHS Foundation Trust, Edward Palfrey, Director of Clinical Integration, Frimley Park Acquisition Project team and Jane Hogg, Integration Director, Frimley Park NHS Foundation Trust.

The Chairman read the following introduction.

"Wexham Park Hospital is just over the county border in Slough but serves a large proportion of residents in South Bucks District as well as some residents in Chiltern and Wycombe Districts.

We have been concerned by recent Care Quality Commission Inspection reports into the Hospital over the course of 2013/14.  The latest was published earlier this month following their inspections in January.

We are particularly concerned by the Chairman of the Care Quality Commission in an interview with the BBC in April commented that Wexham Park was a Hospital he would not want to attend as a patient.

Alongside these concerns over the quality of service provision, Frimley Park Foundation Trust is in the process of acquiring the Trust that operates the Hospital."

Mr Macdonald made the following main points during his presentation.

• The Trust accepts the findings of the CQC and is committed to addressing the issues raised.
• The Trust has worked hard to address concerns raised in earlier reports and made progress but recognises the scale of the challenge that there remains significant work to be done to deliver the improvement required.
• The Trust is of the view that it continues to require external support to deliver the changes required. 
• The aim is to make rapid improvement alongside continuing the longer term work.
• The Trust has been given and put in place a number of arrangements to assist with the ongoing improvement programme, including an Improvement Director, appointed by Monitor; an experienced Director of Nursing; partnering with Frimley Park Hospital and ACAS review and training.
• The Trust is committed to playing its full part in preparing for the potential acquisition by Frimley Park Hospital NHS Foundation Trust and recognises that this is the most effective way of delivering a sustainable organisation.

Mr Palfrey made the following main points.

• The closure of the maternity services at Heatherwood and Wexham Park lead to more patients visiting Frimley Park and therefore a need to plan services across the Hospitals.
• The CQC inspection has identified problems at Heatherwood and Wexham Park which has resulted in an action plan being developed to address the issues.
• The Trusts are now in the middle of a change process which includes the infrastructure and the governance of the Trust.
• In the Acute Hospital setting, good communication is extremely important.

During discussion, Members asked the following questions.

·         What is, and what will be, the financial impact on the Trust of the recent CQC inspection reports given the scale of improvement now needed and how will this be funded to ensure service improvements are not delayed?  Mr Macdonald responded by saying that there are one-off costs to pay for the help and this has been agreed with the Regulator.  The additional costs will  ...  view the full minutes text for item 7.

For members to review the delivery of the recommendations made in their April 2013 report.

Contributors

Patricia Birchley – BCC Cabinet Member Health and Wellbeing

April Brett – BCC Public Health Team

Papers

Reducing Alcohol Misuse 12 month update

The Chairman welcomed Patricia Birchley, Cabinet Member for Health and Wellbeing, April Brett from the Public Health team, Isobel Ellison from Resources and Kirsty Henderson, Health & Wellbeing Administrator. 

The Chairman explained that the Committee published its report on reducing Alcohol misuse in April 2013.  The inquiry group was chaired by Jenny Puddefoot and comprised Lin Hazell, Wendy Matthews and Nigel Shepherd.  The report was concerned with the long term health impacts of drinking beyond recommended levels.  During the inquiry, the working group found that there was a need to raise awareness of this problem and challenge perceptions that the problem is with young binge drinkers.  In fact, the health impact of older age groups drinking regularly at home is just as concerning.  The inquiry felt there was a role in reducing levels of alcohol misuse via initiatives in workplaces, retailers, A&E and through licensing legislation.  Seven recommendations were made, with 6 of them directed at the Health and Wellbeing portfolio and one directed at the employee wellbeing service within the Councils finance and resources portfolio.

The Cabinet Member started by stressing that the County Council takes alcohol misuse very seriously and it is one of the four main health concerns which are highlighted in the joint strategic needs assessment with our health partners.  However, the levels of alcohol misuse are lower in Bucks than the national levels.  There has been a reduction in the number of 18s involved in alcohol misuse and this is extremely important going forward.  The main area of concern is around middle aged and professional people who are drinking above the national limit in their homes. 

The questions below relate to the recommendations within the report.

Recommendation 1

·         Among all the other awareness raising activity undertaken detailed in the update, there is reference to an "Alcohol in the Workplace Guidance pack".  Is it possible to have a record of the workplaces that engage with this so that the Committee can have an idea of its dissemination and to open up communication channels with interested workplaces?  Ms Brett responded by saying that it will be an electronic resource as there is an alcohol web page.  It will be able to record who has accessed this but it is voluntary.  The team will be notifying Bucks Business First so that they can link in with it.

Recommendation 2

·         The inquiry group heard a lot of positive evidence on the impact of Identification and Brief Advice (IBA) in reducing peoples’ alcohol intake.  Please could you clarify if the Bucks County Council’s Occupational Health Advisor is providing this to staff and will they report on how much IBA activity they undertake?  Ms Ellison responded by saying that occupation health is undertaken by an organisation called People Asset Management who came on board in September last year.  As part of their remit, they look after occupational health.  One of the difficulties in recording alcohol misuse as a employer, is that it is not very forthcoming on the notes when an  ...  view the full minutes text for item 8.

Contributors

James Povey, Scrutiny Policy Officer

Papers

The Health & Adult Social Care Select Committee Work Programme

Members were asked to note the work programme.  The Care Bill will be discussed at the June meeting.

The next meeting is due to take place on Tuesday 24 June 2014 at 10am in Mezzanine Room 2, County Hall, Aylesbury.

The next meeting is due to take place on Tuesday 24 June 2014 at 10am in Mezzanine Room 2, County Hall, Aylesbury.