Meeting documents

Apologies were received from Mrs Angela MacPherson, Mr Brian Roberts, Mrs Patricia Birchley, Mrs Shade Adoh, Mr Nigel Shepherd and Mr Tony Green.

There were no declarations of interest

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

The minutes of the meeting on 24^th September 2015 were confirmed as a correct and accurate record.

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/getting-involved/

There were no public questions

This will include responses to committee questions raised at the 24^th September meeting regarding; Care Homes Inspections and waiting times for Occupational Therapy. In addition there will be a response to a question from a member of the public concerning bowel screening.

The Chairman updated the Committee on the response from the Public Health Team regarding the following question raised on behalf of a member of the public

‘‘Why is there inequality in screening for bowel cancer? In England it is at 60 years of age, whilst in Scotland it is at 50 years of age?’

Response: In England: 

‘For men and women aged 60-74 in England there is a universal screening  test. The NHS Bowel Cancer Screening Programme offers screening every two years The test checks for the presence of blood in a stool sample, which could be an early sign of bowel cancer. In Scotland this offered from 50 -74 year lower

An additional one-off t test called bowel scope screening is being introduced in England. This is offered to men and women at the age of 55 years. It involves a doctor or nurse using a thin flexible instrument to look inside the lower part of the bowel and remove any small growths, called polyps, that could eventually turn into cancer.  NHS Scotland is now offering bowel scope screening to some men and women aged around 60.’

Julia Wassell raised a query concerning future provision at Wycombe General  Hospital. There is a planning process to update the older part of the Hospital. and a need to find out from the Trust what the timescale for replacement is. Julia Wassell stated that the minutes of the Trust Board noted a decision will be made in March 2016 with completion in April 2018 and yet it is unclear what is involved. Julia Wassell will submit a written question to the Chair of HASC regarding her queries and concerns. Mr Noel Brown raised concerns that the Trust had not notified HASC.

Mrs Margaret Aston raised concerns regarding the funding and future funding of NHS dentistry in Buckinghamshire. HASC will investigate the issue and may add this item to their work programme. Responding to a query from Mr Noel Brown HASC will also investigate who to go when raising a complaint.

For members to receive an update on the progress towards quality improvements, future plans for trust sites, services and impacts on residents.

Contributors:

Andrew Morris, Chief Executive of Frimley Health Trust

Reports:

Frimley Health Trust Overview paper from Andrew Morris

Andrew Morris provided Members with a verbal overview the progress towards quality improvements, future plans for trust sites, services

and impacts on residents. See PAPERS AND WEBCAST FOR FULL DETAIL.

During the discussion the following areas were covered:

·         Frimley Hospital Trust employs 8,200 people, the budget is £600 million and is the 12^th largest organisation in the NHS. Frimley has contact with approximately 1 million people per year.

·         There have been significant improvements since the Trust took on Wexham Park and Heatherwood. Wexham Park has delivered on all it’s Monitor standards

·         The Trust has recently had it’s CQC Inspection involving 45 Inspection staff over 3 days. Results will be known in 6-8 weeks. Trust is also due an unannounced inspection.

·         Changing work culture important strand of improvements, treating people as customers.

Key areas are:

·         The development of the Emergency Centre – a £45 million investment with a short stay assessment unit with referral to specialities if needed. Wrapped around this will be point of care testing, with CT scanner, Ultrasound and Radiology facilities. People will be seen in a private room if they require admission. It will take 2 years to develop. Improving cancer services. The Trust is looking to provide radiotherapy at the Slough site, working in partnership with Royal Berkshire NHS Trust.

·         Developing a brand new bespoke elective centre at the Heatherwood site costing £65 million. A land sale will help finance this. It will comprise 6 operating theatres, 48 beds, day case places for surgery and outpatient facilities and diagnostics.

·         The move towards consultant delivered services at Wexham. The NHS is moving towards more of a consultant delivered offering.

·         Complaints to the Trust are down.

·         Staffing is a huge issue for the Trust, particularly on the Wexham site, against national shortage. The Trust has made an offer to 120 nurses from the Philippines who train to US standards. Also committed to training and preceptorship as a mechanism to retain staff.

·         The Trust has support from the local senate and CCG to provide a 24/7 heart attack service on the Wexham site.

Questions raised by members

·           The amount of community engagement particularly around issues such as car  parking and importance of bus links

·           The Trust making links with training providers to improve recruitment of nurses

·           Overly bureaucratic processes regarding DBS checks

·           What will be covered by the maternity upgrade.

To provide Members with an overview of quality assurance processes

Contributors:

Rachel Rothero: Service Director Communication and Service Improvement, Adult and Family Wellbeing Services, BCC

Report: Overview paper of quality assurance processes.

Rachel Rothero and Graham Finch provided Members with an overview of local quality assurance processes. SEE PAPERS AND WEBCAST FOR

FULL DETAIL

During the discussion the following areas were covered:

·         New responsibilities under the Care Act. Care Quality Commission (CQC) for market oversight and Local Authorities for continuity of services if a provider / facility fails.

·         The care market seeing a polarisation between self-funders and Local Authority (LA) funded. LA’s are effectively competing with self-funders and Clinical Commissioning Groups (CCG’s). Limitations in the market are staffing availability. Biggest risks are linked to supply of nursing and care staff and financially the introduction of the national living wage and how this will be funded. New entries into the market are targeting self-funders. However LA is still biggest purchaser.

·         More work needed to help proactively prepare and forward plan for care and support.

·         New respite responsibilities driving up demand for short term placements.

·         Factors that affect market stability including organisational structure, turnover, regulation responsibilities. Increasing risk is employment related factors.

·         Market failure risk locally attached to local providers of 150 -200 bed facilities.

·          The responsibilities and steps the Council and the Care Quality Commission take to have oversight of the Care Market at 3 tiers of oversight and intervention

Questions raised by members concerned:

·         New approaches to recruiting nursing and care staff.

·         Potential duplication of processes

·         Differentials in inspection standards for nursing and residential care.

·         Looking at best practice of delivery mechanisms

For Members to note the Work Programme

The Committee noted the work programme.

The next meeting will take place on Tuesday 24^th November at 10.00am in Mezzanine Room 2, County Hall, Aylesbury. There will be a pre-meeting for Committee Members at 9.30am.

The next full webcast committee meeting will be on 24^th November 2015 at 10:00am.

For members to review day care opportunities across the County.

Contributors:

Mike Appleyard, Deputy Leader and Cabinet Member for Health & Wellbeing

Ainsley Macdonnell, Strategic Service Manager, Adult and Family Wellbeing Services, BCC.

Rachel Rothero, Service Director Communication and Service Improvement, Adult and Family Wellbeing Services, BCC

Kelly Taylor, Project Manager-Strategic Accommodation Development & Transformation of Day Opportunities, Adult and Family Wellbeing Services, BCC

Reports:

Day Care Opportunity Centre Overview paper

Rachel Rothero, Ainsley MacDonnell and Kelly Taylor and Cllr Mike Appleyard provided Members with an overview of the review of day care opportunities across the county. SEE PAPERS AND WEBCAST FOR FULL DETAIL

 During the discussion the following areas were covered:

·         Transparent that driver of changes was to make savings on a recurrent basis. Under personalisation also had to create a market place which led to creation of Buckinghamshire Care. Driver was also ensuring value for money, improving quality and better utilisation.

·         Service has made £3 million savings and have further half a million worth of savings built into the Buckinghamshire Care Contract

·         Still have issues around development of Wycombe site, now looking at completion in 2018 and back to looking at utilising Orchard House site.

·         Burnham will open in Mid-November 2015.

·         Thrift Farm will become a key part of income generation and the services at the site are aimed at people with learning disabilities.

·         Built demographic growth into the capacity of the new build.

·         One of key strategies of Buckinghamshire Care is to income generate and as part of this creating marketing and promotion strategies.

·         Buckinghamshire Care is responsible for Community Engagement and a lot work is needed in engaging people who are not presently clients.

·         Encouraging GP’s to signpost to the centres particularly where there are social isolation concerns.

Questions raised by members

·         Types of contracting models the service is considering to ensure value for money and stability

·         Centres apparent under-utilisation and problems with staff recruitment

·         Differential pricing regarding self-funders and full charge County-Council funded.

·         The catchment areas of the Centres.

·         Planned engagement of BME community and older people.

·         Promotion of what the centres will offer older people, utilising the Local Area Forums to promote centres and services.

For Members to consider more detailed business information relating to Day Care Opportunities

The business information was noted.