Meeting documents

Apologies were received from David Martin, Brian Roberts, David Carroll, Freda Roberts, Nigel Shepherd, Julia Wassell and Shade Adoh.

There were no declarations of interest.

of the meeting held on Tuesday 24 June 2014 to be confirmed as a correct record.

The minutes of the meeting held on Tuesday 24 June 2014 were agreed as a correct record.

Matters arising

·         A letter of thanks has been sent to the Whiteleaf Centre.

·         County Councillor Noel Brown said that he no longer has contacts at Oxford Health.

·         The Adult Social Care 15 minute visit will be discussed at the next Committee meeting in October.

·         The Education and Skills Select Committee Inquiry began with a Special Meeting of the Committee, which took place on 8^th September 2014 and will continue until Spring 2015, with the Committee maintaining oversight of the improvement of children’s social care over the next 18 months.  At this meeting the Committee received oral evidence from the Leader of the Council, Mr Martin Tett and questioned the Cabinet Member for Children’s Services, Mrs Angela MacPherson, the Strategic Director of Children and Young Peoples Service Mrs Sue Imbriano and the Chairman of the Buckinghamshire Local Safeguarding Children’s Board Mr Donald McPhail.  The Committee will consider the Council’s Draft Improvement Plan for Children’s Services at its meeting on 7^th October 2014 and interview the new Acting Strategic Director of Children and Young Peoples Services and the Acting Director of Children’s Services on 24^th September 2014. 

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/

No public questions have been received for this meeting.

There were no public questions at this meeting.

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

The Chairman updated Members on the following.

·         Children and Adolescent Mental Health Services (CAMHS) – the service is to be re-commissioned in October 2015 and Oxford Health NHS Foundation Trust is the current provider.  This service is funded 75% by the NHS and 25% by the Local Authority.  The Chairman has met with the commissioners and Members will be invited to Stakeholder consultation events from mid-October.  The Committee will receive an information paper at the next meeting after which the Committee will decide what level of involvement it wishes to have in the re-commissioning process.

·         Maternity Needs Assessment & Services Review – Members should be aware that the Clinical Commissioning Groups are undertaking this review to look at current service provision, pathways and need.  There is stakeholder and user engagement underway and a final report is expected in November.  There may be some media coverage of this and the Committee will await the final report with interest.

·         MK & Bedford Healthcare Review – this review has been underway since January 2014 and a report is expected on the 23^rd September which will outline the next steps with the review and options for consultation.  This is expected to concern a number of residents in the north of the county.  The Chairman has written to the Milton Keynes Clinical Commissioning Group to ensure the Committee is kept updated with proposals and to clarify the consultation activity that has been undertaken to date in the north of the county.

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

District Councillor Tony Green reported that Wycombe District Council Improvement and Review Commission are undertaking further work on Urgent Care and as part of this, they are holding a public listening event on 15^th October at 7pm at Bucks New University.  He encouraged people to attend.

For Members to question executives from the Trust on their most recent CQC inspection report, ongoing quality improvement programme, and revisit areas highlighted in the HASC inquiry into the 2013 Keogh Report on the Trust.

Contributors

Anne Eden – Chief Executive, Buckinghamshire Healthcare NHS Trust

Dr Tina Kenny – Medical Director

Carolyn Morrice – Chief Nurse

Annet Gamell – Chief Officer, Chiltern CCG

Lou Patten – Chief Officer – Aylesbury Vale CCG

Papers

BHT Quality Improvement Strategy

BHT Quality Improvement Plan

Copy of BHT’s response to the Committee’s Keogh Inquiry in 2013

The Chairman welcomed the following representatives from the Buckinghamshire Healthcare NHS Trust - Anne Eden (Chief Executive), Dr Tina Kenny, (Medical Director), Carolyn Morrice (Chief Nurse) and Lou Patten (Chief Officer, Aylesbury Vale Clinical Commissioning Group). 

Annet Gamell sent her apologies.

The Chairman started by saying that the Committee last heard from the Trust at its meeting in April 2014 where it looked at the quality improvements made after the Keogh Review into the Trust in the Summer of 2013, which was triggered by higher than expected mortality rates.  The Keogh report was highly critical of the Trust and placed it in "special measures".  The Committee conducted its own review of the Keogh findings and published its own report in October 2013 which included a number of recommendations.  Since the April meeting, the Care Quality Commission has published its inspection findings and the Trust has come out of special measures.  The Chairman congratulated the representatives from the Trust on this achievement.

During her presentation, Ms Eden made the following main points.

·         The CQC inspected Amersham, Stoke Mandeville and Wycombe Hospitals in March 2014 and published their findings and recommendations in June 2014.

·         Overall, the Trust has been given a "requires improvement" rating.  It has been rated "good" for caring which reflects passion and commitment of staff.

·         It is a whole system approach involving the Ambulance Service, Social Care Services, Clinical Commissioning Groups, Mental Health Service and GPs.

·         The Trust’s HSMR (mortality rate) is now well within the expected range.

·         The greatest area of concern is around "end of life" care and this is where a lot of work is being undertaken to improve this.

·         The CQC acknowledged that the improvements made to date have been "significant".

·         The Trust has developed a quality improvement plan with 10 ‘must do’ actions and a number of ‘should do’ actions.  Some actions have already been completed.

·         Jane McVea has been appointed as the Quality Improvement Programme Manager and she is helping with implementing the action plan.

·         It is important to take the actions down to ward level so everyone knows their role in making the necessary changes.  All the changes need to be sustainable beyond just the CQC inspection period.

·         Every death is reviewed and lessons are learnt.

·         The whole system is working together to make the necessary improvements.

·         The Quality Improvement Strategy has three ambitious aims:

o   To reduce mortality;

o   To reduce harm;

o   A great patient experience.

·         Underpinning the quality improvement strategy, is the need for cultural change throughout the Trust.

·         Funding has been put in place for Winter resilience to put in place extra capacity during these months.

·         A&E attendances have increased by 5-6% compared to April-August last year.

·         There are internal and external nurse staffing level reviews currently underway.  Staffing levels are published on wards and the website.

·         There has been a £5million investment in increasing staffing levels:

o   232 qualified nurses were recruited in 2013/14;

o   153 qualified nurses have been recruited since April.

·         Staff recruitment and  ...  view the full minutes text for item 7.

For Members to receive an update from the Inquiry Group Chairman on progress with the Committee inquiry into GP service provision.

Roger Reed, Chairman of the GP Services Inquiry Group, provided the following update.

·         The first evidence session was held on 27 August.  NHS England Thames Valley Area Team, the local Medical Committee, local Clinical Commissioning Groups, Healthwatch and the Care Quality Commission all attended the session.

·         GP service user feedback has been obtained which has identified areas of both satisfaction and dissatisfaction with services.

·         The inquiry group is now undertaking visits to 11 GP practices to speak with staff about variation and patient experience, the demands on the service and how practices are delivering their service in response to these.

·         There will be a final evidence session with NHS commissioners and the Local Medical Committee on 24^th October.

·         The findings and recommendations will be reported to the Committee on 25^th November and then it will be presented to the relevant agencies for a response.

Contributors

James Povey – Scrutiny Officer

Papers

The Health & Adult Social Care Select Committee Work Programme

Members were asked to note the following changes to the Committee work programme.

·         Adult Social care 15 min visits to be pushed back to October (due to policy proposals not being finalised yet).

·         The Health and Wellbeing Board Annual report item has been pushed back from October to November (to accommodate the finished report).

·         The Primary Care Strategy has been added to the work programme for February 2015.

·         The item to look at either Palliative Care in the Community and/or Adult Social Care Outcomes has been removed from the programme and will be considered when the next inquiry is discussed.

·         The Children and Adolescent Mental Health Services (CAMHS) paper on the re-commissioning exercise will come to the October meeting.

The next meeting is due to take place on Tuesday 28 October 2014 at 10am in Mezzanine Room 2, County Hall, Aylesbury.

The next meeting is due to take place on Tuesday 28 October 2014 at 10am in Mezzanine Room 2, County Hall, Aylesbury.

Future dates in 2014

Tuesday 25 November

Proposed dates in 2015

Tuesday 10 February

Tuesday 24 March

Tuesday 28 April

Tuesday 26 May

Tuesday 30 June

Tuesday 15 September

Tuesday 20 October

Tuesday 24 November