Meeting documents

Apologies received from Ms S Adoh, Mr D Carroll, Mr R Reed, Mr B Roberts, Mrs J Teesdale.

Membership changes: Following full council, changes are that; Mr A Huxley is no longer a member of the committee. Brian Adams will remain as the 1 UKIP representative (reduction from 2 to 1 member).

Mr D Hayday joins the committee as Independent Representative.

There were no declarations of interest.

Minutes of the meeting held on 24^th March 2015 to be confirmed as a correct record.

The minutes of the meeting held on Tuesday 24^th March 2015 were confirmed as a correct record subject to the following amendment:

Add to attendees  - Dr Malcolm Jones.

There are two outstanding actions to be followed up and reported back at the next meeting. These are:

1)    Action for the Chairman to feedback to the committee when a response is received from NHS Blood and Transplant – this is in relation to issues raised at committee meeting on 24^th March (see minutes of the meeting). The action has been chased and awaiting response.

2)    Action for CCG’s to provide a summary of the £30m of extra funding provided and their plans for this (see minutes of meeting on 24^th March for detail). This action has been chased and a response is expected imminently.

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 Chairman has received two public questions as follows:

In relation to Item 8: Part Two, Local Area Trading Company, Buckinghamshire Care. The question received from Margot Hill is:

"How will the third additional tier of management improve communication and support to front line staff who are at the same time having to sign new contracts that give them less flexible working conditions?"

In relation to Item 9: Buckinghamshire Healthcare Trust. The question received from Ozma Hafiz is:

"What guarantees can be given that the services we currently have including the Cardiac/Stroke and Maternity unit will still be on Queen Alexandra Road in 5-10 years time? What are the future plans for the Wycombe Hospital site?"

The following public questions were received:

1.    Question received from a member of the public:

"Buckinghamshire Care is a new company that has recently restructured and brought in another tier of management at a time when other organisations are de-layering to focus on the support for front line staff                                   .                                                                                   
How will this third additional tier of management improve communication and support to front line staff who are at the same time having to sign new contracts that give them less flexible working conditions".

This question was dealt with under item 8 on Buckinghamshire Care. SEE MINUTES FOR THIS ITEM AND WEBCAST FOR DETAIL.

2.    Question received from member of the public:

"What guarantees can be given that the services we currently have including the Cardiac/Stroke and Maternity unit will still be on Queen Alexandra Road in 5-10 years time? What are the future plans for the Wycombe Hospital site?"

This question was dealt with under item 9 on Buckinghamshire Healthcare Trust.  See minutes for this item and webcast for detail.

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

The Chairman advised that Freda Roberts will not be standing in the District Elections this time round. The Chairman thanked Ms Freda Roberts for all of her, support and dedication to the work of the committee over the years.

The Chairman informed the committee that she and Mr R Reed will be visiting the Whiteleaf Centre on Thursday 30^th April and will report back to the committee at the next meeting.

The Chairman gave an update on the Public Health launch of Active Bucks and the role of councillors in promoting active communities.

Mr B Adams informed the committee that as a member, he has had recent feedback from his local patient participation group.

Ms W Matthews, informed the committee that in working with the LAFs her local area has set up two Movers and Shakers clubs for elderly residents in the local area.

For members to scrutinise the operation of Buckinghamshire Care, the Local Area Trading Company (LATC) launched in 2013 to deliver adult social care services.

Part 1 will examine the setup of the LATC, its governance, financial performance and lessons learnt over the past eighteen months.

Graeme Finch, Contract Manager, Susie Yapp, Service Director.

Mr Graeme Finch, Contract Manager provided an overview of the LATC, highlighting the key points raised within the information paper – SEE PAPER/WEBCAST FOR CONTENT.

The following issues were raised by the committee: Governance structures and the role/terms of reference of the Shareholder Commissioning Group (SCG) as an advisory body and its membership, the roles and remit of the board of directors, the governance around dividends, the level of influence of SCG, the advantages and implications of Teckal Status and value for money and efficiencies of the delivery model as well as lessons learnt in the first 18 months since setting up the LATC (in particular around culture change).

Other matters raised concerned the performance and slowness of sales of services to other local authority areas as originally planned in the business case. It was highlighted that this was due to other local authority areas also adopting LATC delivery models. It is also relatively speaking in its infancy and opportunities to sell services have not yet arisen.

See Webcast for full details of the discussion.

ACTION: To have a follow up item on LATC on the work programme committee for 6-12 months’ time.

For members to scrutinise Buckinghamshire Care, the providers of adult social care services. Members will examine its services, its clients, its aims and objectives and its performance.

Martin Farrow, Managing Director Buckinghamshire Care

Mr Martin Farrow, Managing Director provided an overview of the key points within his information paper: SEE PAPER AND WEBCAST FOR DETAIL.

The following issues were raised by the committee: the challenges and opportunities faced by the service provider, challenges around recruitment and retention in getting the right people in to social work, the overall aims, objectives of the service provider and how performance against them is measured, the visibility and transparency of service objectives and performance particularly in relation to service user experience of services, options for other services to include/deliver going forward to ensure person centred approach to care and prevention agenda, the services delivered within  the community, where they are, how they are promoted and access to them.

In relation to where services are delivered, it was raised that Wycombe has a lack of coverage of day care opportunities provision. It was discussed that plans are in process to identify suitable locations for a site in Wycombe.

ACTION: Susie Yapp to update on the timeframes for site opportunities for Wycombe.

Other matters arising were around staffing and recruitment and whether or not this has had any negative impact on service delivery to date.

The public question raised in relation to Buckinghamshire Care as highlighted in item 4 was raised here. The Chairman asked the question in the absence of the member of public. The repose can be found on the webcast at approx. 11:06 am answered by Martin Farrow.

Martin Farrow also highlighted a review with the Tizzard Group is taking place which is looking specifically at the services in relation to adults with Learning Difficulties.

ACTION: Martin Farrow to share outcomes of this review with the committee at appropriate time.

For members to scrutinise performance and the ongoing quality and service improvements being made by the Trust. As part of this members will re-visit the actions they recommended in their October 2013 report published in response to the Keogh report into the quality of care at the Trust (published in July 2013).

Neil Dardis, CEO, Buckinghamshire Healthcare Trust, Carolyn Morris, Chief Nurse, Dr Tina Kenney, Medical Director.

Neil Dardis presented an overview of the presentation slides and detailed information provided to members in their agenda packs: SEE PAPERS AND WEBCAST FOR DETAIL.

The following issues were raised by the committee: improvements to end of life care and mortality reviews, improvements being made to drive long term planning of recruitment, training and retention of staff, drives towards integrated records across the NHS and electronic discharge papers, BRAVO and ensuring that triage process improvements lead to patient being seen by the right person first time, improvements being made to ensure seamless integration from patient perspective. Matters around health representation at the Multi Agency Safeguarding Hub were also discussed.

Other matters arising included questions around services delivered in Wycombe, (Xray services and impact on number of people attending Stoke Mandeville) and long term plans for Wycombe, the public question highlighted in item 4 was asked here and responded to by both BHT and the CCG, and expanded upon by Wycombe members. National reports were referred to around guidelines for what clinical specialities are required to be co-located.

See webcast for response to public question.  

The Chairman reminded the committee many areas regarding Wycombe hospital have already been covered in full at previous meeting and the committee are awaiting Wycombe District Council’s report. National guidance reports referred to would be circulated to members again for information.

Action: Kama Wager to ask Louise Patten for national reports referred to and circulate to members.

The Chairman asked for an update on the investigations into the recent incident where a dementia patient died after walking out of Stoke Mandeville. The committee were informed that system wide briefing took place to ensure immediate mitigation measures were taken, a full investigation is taking place and lessons learnt are being acted upon.

ACTION: Carolyn Morrice, Chief Nurse, to provide a brief written status update on outcome of the investigation.

The Chairman highlighted committee’s recommendations on the Keogh report have now been covered by many of the quality improvement programmes taking place within BHT. However the Chairman requested a brief final written response in order to close down the recommendations and update the website with the final response.

ACTION: BHT to provide a brief final written response to each of the recommendations addressing how they have been implemented or superseded by other improvement works taking place.

For member to agree the inquiry scope for 15 min domiciliary care visits and agree membership of the inquiry group.  

The committee considered the scope for an inquiry into 15 Min domiciliary care visits. Members agreed the scope with the addition of Mr B Adams and Mr N Brown to the inquiry group membership.

Action: For Committee Advisor to develop the evidence schedule for the inquiry and set evidence sessions.

For members to consider the committee work programme and suggest topics for work programme development.

The Chairman highlighted that the committee would prioritise the 15 min visit inquiry until the summer. The committee will then focus on the LD inquiry which will commence evidence gathering in September. The committee agreed.

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

The committee discussed areas to be considered in the development of the work programme. These included:

·         Better Care Fund

·         End of Life Care update ( early 2016)

·         Healthwatch and work on configuration of community services.

·         Day care centres

26^th May 2015

The date of the next meeting is the 26^th May 2015.