Meeting documents

Apologies received from Mr B Adams, Mr N Brown and Ms J Teesdale

Mr S Lambert was substituting for Mrs A Davies

There were no declarations of interest.

The minutes of the meeting held on Tuesday 10^th February 2015 were confirmed as a correct record.

Matters arising

The Chairman would provide an update on the Female Genital Mutilation topic under Agenda Item 5.

The Chairman had raised the issue of information sharing on the Cressex Health Centre new provider with the NHS England Thames Valley Area Team.

Mr J Povey confirmed that the Better Care Fund HASC sub-group had met with Lesley Perkin, the Programme Director for Integrated Care, to discuss progress.

Mr J Povey advised that Ms K McDonald had updated the Health and Wellbeing Board governance slide as requested, and that this had been published as a paper for the last Board meeting on 5^th March.  The March Board meeting was held in Amersham, and the next would be in Aylesbury, but venues of the meetings after that had not been agreed.  Ms McDonald was looking at venue options, and had been provided with contact details of Mr Green and Ms Teesdale to facilitate a High Wycombe venue.  Ms McDdonald had advised that in lieu of an annual report for 2015, a ‘measuring success’ report would be published in the summer to accompany the governance report published in March.  An updated communications and engagement plan would also be published in the summer, around the time of the June Board Meeting. 

Mr J Povey advised that further responses to the HASC GP Inquiry had been requested and now received.

NHS engagement in planning matters would be covered in more detail under Agenda Item 8.

The draft scope for the new HASC inquiry which would be on Services for Adults with Learning Disabilities was in the papers to be discussed under Agenda Item 9.

The Committee had provided comments on the CCG response to our concerns over ambulance response times, and this had informed the subsequent correspondence detailed in the papers.

Mr J Povey and the Chairman clarified that the issue with blood donation services in High Wycombe did not seem to be a lack of sessions in the area, but a lack of a town centre venue, with Adams Park being the town venue currently.  NHS Blood and Transplant had been contacted on this matter, and a response is awaited.  Comments were made on the poor accessibility of Adams Park, and why sessions were not at workplaces.

Action: Chairman to feedback to the committee when response is received from NHS Blood and Transplant

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.

There were no public questions.

There is guidance on how to submit public questions on the Council’s website: www.buckscc.gov.uk/about-your-council/scrutiny/guidance/

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

·         HASC letter 2 to SCAS and CCG on Ambulance Response Times

·         CCG response to HASC  Letter on SCAS Response Times

·         HASC Letter to PB on AFW Consultations March 2015

The Chairman informed the committee Mr J Povey would no longer be supporting the committee, and thanked him for his work over the past two years.  Ms K Wager was introduced, and would be supporting the committee in future.

The Chairman advised that in response to continuing committee concerns over the adequacy of the Council’s domiciliary care service, the committee would be undertaking further work on this comprising an audit of care visits, and committee members shadowing carers on their shift.  Ms Adoh, Mr Shepherd, Mrs Aston, Mr Reed and the Chairman volunteered to be involved in the work, and would report back to the committee and Cabinet Member.

Action: Chairman to feedback to the committee following the domiciliary care worker shadowing and audit exercise

The Chairman referred to Agenda item 5, appendix 2 which was a proposed response to the two recent Adults and Family Wellbeing consultations on Sheltered Accommodation, and Charging Policy.  Following a brief discussion it was agreed to send the response to the Cabinet Member.

Action: Chairman to send consultation response to Cabinet Member for Adults and Family Wellbeing.

The Chairman gave an update from the meeting of the Better Care Fund (BCF) HASC sub-group, and advised that she had expressed an interest to receive more detail on impact monitoring of the fund and specific elements of it when this was available.  Also that Tier 1 and 2 of the BCF programme would be looked at alongside our Public Health activity in a future committee meeting in 2015.

The responses received on ambulance response times were referred to - see Agenda Item 5 papers.  The committee had no further comments.

The Chairman advised that an update on Frimley Health NHS Foundation Trust who operate Wexham Park Hospital, had been received and circulated to the committee.  This would be added to the meeting papers online.  Following a discussion on further updates desired, and Frimley Health’s arrangements to engage with Chiltern CCG and the Councils Adult and Family Wellbeing Service, it was agreed that the Frimley Health Chief Executive be invited to a future committee meeting in 2015.

Action: Chairman to invite Frimley Health Chief Executive to future HASC meeting

The Chairman advised that she had attended a Milton Keynes CCG public engagement event in Buckingham a couple of weeks ago, which she considered to have been poorly advertised and hence was poorly attended.  She would seek more HASC involvement in the work on the future of Milton Keynes Hospital when this picks up after the general election in May.  Ms Patten highlighted the Buckingham & Winslow locality work with MK CCG.

The Chairman advised that Female Genital Mutilation (FGM) work locally was being led by the Buckinghamshire Children Safeguarding Board currently, and to avoid duplication of effort she would contact them and the Adult Safeguarding Board to keep updated on progress in ensuring the necessary arrangements were in place locally.

Action: Chairman to contact the Children and Adult Safeguarding Boards on their FGM activity

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

Ms S Adoh provided an update on Healthwatch activity.  See supplementary paper for full update.

A committee member raised an issue with SCAS 111/999 call handling and signposting to alternative pathways.  In response Mr Battye explained how calls are handled and how patient and GP feedback on these are reviewed.

Members will question local healthcare commissioners and providers on urgent care service provision and performance.  As part of this members will consider progress made against the committee’s urgent care inquiry recommendations agreed in April 2014.  Members will also consider the responses provided to the recent urgent care inquiry conducted by Wycombe District Council’s Improvement and Review Commission, and the Urgent Care Services Review conducted by Healthwatch Bucks.

Contributors

AnnetGamell , Chiltern CCG Chief Clinical Officer

Lou Patten, Aylesbury Vale CCG Chief Officer

Neil Macdonald, Buckinghamshire Healthcare NHS Trust,  Interim Chief Operating Officer,

Peter Boast, Buckinghamshire Urgent Care

Andy Battye, South Central Ambulance Service.

Papers

·         Local Urgent Care presentation

·         SIRI Report

·         Evaluation and forward plans paper – TO FOLLOW

·         HASC Urgent Care Inquiry 12 months recommendations implementation

·         WDC Improvement and Review Commission Urgent Care inquiry responses TO FOLLOW

·         Healthwatch Bucks Review of Urgent Care Services in Buckinghamshire: The Patient Experience. January 2015 Executive Summary.

Dr A Gamell went through the presentation slides, followed by questions from the committee - SEE PAPERS/WEBCAST FOR CONTENT.

The following issues were raised by the committee: how are current levels of high demand and efforts at closer integration any different to previous messages heard on this, distinction between a provider or whole system declaring ‘black’ status and the use of ambulance diverts to alternative emergency departments, paramedic recruitment problems and sustainability of overseas recruitment, longer term efforts at tackling staff shortage and staff housing provision, whether organisational sovereignty was a barrier to closer integration, plans to avoid the impact of bank holidays on the urgent care system and potential costs caused by inflated locum /temp staff costs.  The contribution of adult social care staff was highlighted by the Cabinet Member, and issues with care home admittance was identified as a block on patient discharge.

Other matters raised concerned the adequacy of the paid for bed stock at Buckinghamshire Healthcare Trust, the issue of excessive lengths of stay taking up bed capacity, and the importance of the elderly getting flu jabs.

In connection with the responses to the Wycombe District Council Urgent Care Report in the papers, it was clarified that the Minor Injuries & Illness Unit now had 24hr X-ray provision, the timescales for improved IT integration, and the data that would indicate effectiveness of communications to improve patient understanding of urgent care pathways/services.

NHS 111 call handling effectiveness and monitoring was then queried, followed by the performance and improvements planned for Wexham Park A&E. 

For members to scrutinise the Primary Care Strategy for Buckinghamshire, and question commissioners on the implications and implementation of this over the next few years.  Members will consider the responses provided to the recommendations made in the committee’s GP Inquiry Report (Nov 2014) as part of this item. 

Contributors

AnnetGamell (Chiltern CCG Chief Clinical Officer)

Lou Patten (Aylesbury Vale CCG Chief Officer)

Dr Malcolm Jones (Aylesbury Vale CCG lead for Primary Care Strategy)

Papers

·         Primary Care Strategy

·         GP Inquiry recommendation responses

Dr M Jones went through the Primary Care Strategy and its goals.  It was emphasised that it is not prescriptive but a set of design principles, and the design solutions would likely vary by locality (3 localities in Aylesbury Vale, 4 in Chiltern CCG).  Co-commissioning would enable CCGs to proactively develop local primary care.  The presentation was followed by questions from the committee -   SEE PAPERS/WEBCAST FOR FULL CONTENT.

In scrutinising the strategy members were able to clarify that there would be no additional resource to support the extra CCG responsibility of co-commissioning, but that in doing so CCGs hope to be able to commission services more efficiently and proactively given their expertise in primary care. 

It was highlighted by the Cabinet Member that the CCGs had benefitted from a £30m increase in their budget, although the CCGs clarified this was part of a national initiative to move those previously disadvantaged CCGs nearer to a fairer funding allocation.  Members requested a summary on what this extra resource would be spent on.

Action: CCGs to provide a summary of the £30m of extra funding provided and their plans for this.

Other matters raised concerns how the Strategy links with the Council’s Prevention Matters programme and public engagement and communications on the strategy and its implementation.

With reference to the rejected HASC GP inquiry recommendation (rejected by NHSE) on a waiting time performance indicator, it was queried how the Strategy principle of being accessible with appropriate waiting times would be measured and monitored.  This instigated a discussion around what is appropriate and how patient needs and access could be met more generally.   

There was then a further discussion on another HASC GP recommendation area concerning NHS interaction with the planning system, and public or developer funding for GP buildings and services.

For members to discuss and agree the scope for the committee’s next inquiry, which will be on services for adults with learning disabilities.

Papers

·         HASC inquiry into services for adults with learning disabilities scope

The Chairman summarised the proposed inquiry scope, as detailed in the papers, and invited comments.  There were no comments and the committee agreed the scope.

Decision: the committee agreed the scope for the HASC inquiry into services for Adults with learning Disabilities

Contributors

James Povey – Scrutiny officer

Papers

·         The Health & Adult Social Care Select Committee Work Programme

The Chairman signposted members to the work programme and highlighted forthcoming items.  SEE PAPERS FOR DETAIL.

To note the next meeting of Select Committee on 28^th April 2015

The Chairman signposted members to the work programme and highlighted forthcoming items.  SEE PAPERS FOR DETAIL.