Meeting documents

Venue: Mezzanine Room 1, County Hall, Aylesbury. View directions

Contact: Liz Wheaton 

Note: Please note that this meeting will be webcast - please use the "Webcasts" menu link 

Media

Webcast: View the webcast

Items
Note No. Item

10.00am

1.

Apologies for Absence / Changes in Membership

Additional documents:

Minutes:

Apologies were received from Mr C Etholen, Mrs L Clarke OBE, Mr M Hussain, Ms J Cook and Mrs M Aston.

 

The Cabinet Member and Deputy Cabinet Member for Health & Wellbeing sent their apologies.

2.

Declarations of Interest

To disclose any Personal or Disclosable Pecuniary Interests

Additional documents:

Minutes:

Ms T Jervis, Chief Executive of Healthwatch Bucks declared an interest in item 8 as Healthwatch Bucks undertakes a "Dignity in Care" project which is funded by the County Council.

 

Ms T Jervis also declared an interest in item 10 as she was a Member of the Transformation Board.

3.

Minutes pdf icon PDF 246 KB

To confirm the minutes of the meeting held on Tuesday 19 September 2017 as a correct record.

Additional documents:

Minutes:

The minutes of the meeting held on Tuesday 19 September 2017 were agreed as a correct record.

10.05am

4.

Public Questions

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.  Members of the 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/

 

Question 1 – Health provision in Buckingham

 

District Councillor Robin Stuchbury submitted the following questions in relation to the proposed changes in health provision in Buckingham.

 

"I am seeking assurance that the following will take place:

·         That the Clinical Commissioning Groups will undertake an Equality Impact Assessment before any changes are agreed or implemented; and

·         That the Health & Adult Social Care Select Committee will be kept fully briefed on this issue and will have the opportunity to shape and inform the future service provision on behalf of residents."

The questions will be referred to the relevant health organisation for a response.

 

A number of concerns were raised in relation to the community hubs pilot which were considered by the Task & Finish Group at its meeting (see below). 

 

Following the last Committee meeting, Members agreed to set-up a Task & Finish Group to review the interim report and respond to the Hospital Trust.  The draft response will be discussed by the Committee (see item 12).  The final report for the pilot will be coming to Committee in April 2018 when there will be an opportunity to ask further questions of health partners as part of a full evaluation of the pilot.

Additional documents:

Minutes:

The Chairman welcomed District Councillor Robin Stuchbury to the meeting.  He read out the question he submitted in advance of the meeting in relation to proposed changes in GP provision in Buckingham.

 

"I am seeking assurance that the following will take place:

·         That the Clinical Commissioning Groups will undertake an Equality Impact Assessment before any changes are agreed or implemented; and

·         That the Health & Adult Social Select Committee will be kept fully briefed on this issue and will have the opportunity to shape and inform the future service provision on behalf of residents."

 

The Chairman explained that the question would be referred to the Clinical Commissioning Group for a response.

10.15am

5.

Petitions pdf icon PDF 297 KB

An e-petition on the future provision of GP surgeries in Buckingham has been running over the last few weeks’ and has received over 1,000 online signatures.  Below is a link to the e-petition.

 

https://democracy.buckscc.gov.uk/mgEPetitionDisplay.aspx?ID=3296

 

Papers:

Attached is a response from the Partners at the Swan Practice on this issue.

 

Intended outcome:

Committee Members to discuss the petition and agree their response.

Additional documents:

Minutes:

The Committee received a petition on the future provision of GP surgeries in Buckingham.  The petition would be sent to the relevant health organisation for a response.

 

RESOLVED:
The Committee AGREED to invite health partners and representatives from the One Public Estate to a future meeting to inform Members on the plans for future GP provision.

10.20am

6.

Chairman's update

For the Chairman to update the Committee Members on activities that have taken place since the last meeting.

Additional documents:

Minutes:

The Chairman reported the following:

 

·         Member visit to Stoke Mandeville Hospital;

·         Member visit to South Central Ambulance Service control centre;

·         BOBW Sustainability Transformation Plan Scrutiny Chairman meeting;

·         Health & Social Care Integration Summit;

·         Member visit to Wycombe Hospital.

 

Buckinghamshire Healthcare NHS Trust’s Board meeting would be taking place on Wednesday 29th November at Wycombe Hospital.

10.25am

7.

Committee Update

An opportunity to update the Committee on relevant information and report on any meetings of external organisations attended since the last meeting of the Committee.  This is particularly pertinent to members who act in a liaison capacity with NHS Boards and for District Representatives.

Additional documents:

Minutes:

Committee Members provided the following update:

 

·         Ms J Wassell attended a Community Assembly organised by Public Health and Community Impact Bucks.

·         Ms S Jenkins reminded Committee Members about the Vale of Aylesbury Plan which was currently out for consultation.

10.35am

8.

Care Homes pdf icon PDF 298 KB

The purpose of this item is to provide the Committee with an overview of the Care Homes market in Buckinghamshire and to review the quality of care.

 

Attendees:

Jane Bowie, Director of Joint Commissioning, Health and Adult Social Care

 

Papers:

Presentation attached

 

Intended outcome:

For Members to review the quality of care around the Care Homes being used by Adult Social Care.

 

 

Additional documents:

Minutes:

The Chairman welcomed Ms G Rhodes-White, Interim Executive Director of Adult Social Care and Ms J Bowie, Director of Joint Commissioning.

 

Members noted the presentation which was included in the agenda pack.  The following questions and issues were raised during the discussion.

 

·         Ms Bowie agreed to provide the number of Adult Social Care clients currently in care homes rated ‘requires improvement’ or  ‘inadequate’, to the Committee after the meeting.

Action: Ms Bowie

 

·         There was no specific timeframe for care homes rated "requires improvement" to be re-inspected but it was expected to be within 12-18 months from the initial inspection.

·         Ms Bowie explained that a care home provider would be responsible for implementing the action plans but it would be closely monitored, on a monthly basis, by the Care Quality Commission and the Local Authority.

·         Monthly meetings take place with all interested parties to share intelligence and to raise particular concerns.

·         Best practice was shared, particularly relating to those care homes rated "Outstanding".

·         In response to questions around the Council’s contract management arrangements, Ms Bowie explained that the quality of a care home relied on the care home Manager which the Council was not responsible for.  However, the Commissioning team would conduct visits (announced and unannounced) and would work with providers to make improvements to the quality of care.  The Council was now part of a consortium with 11 other local authorities in the region who had set-up an electronic system for sharing real-time CQC information.

·         A Member asked about the robustness of the action plans to which Ms Bowie confirmed that the actions were suitably prioritised and the focus was on making a positive difference.

·         In response to a question about the number of care homes in Bucks that were commercially-run and those run by charities, Ms Bowie agreed to send this information after the meeting although she stressed that the expectations would be the same irrespective of this.

 

Action: Ms Bowie

 

·         A Member asked whether there were enough staff in the complaints team and whether the whole system was utilised to better understand the concerns, pressures and challenges.  Ms Bowie confirmed that it was an ongoing process and gathering feedback was part of the process.  Care workers, visitors and organisations offering specialist services were the "eyes and ears" and feedback was actively encouraged.

·         Members felt that they wanted to view, at first hand, some of the care homes across the County and also to understand the complaints process in more detail.  It was agreed to set-up some visits in the New Year.

 

Action: Ms Bowie

 

·         Members asked to have early sight of the "Quality in Care Team" evaluation report which was due to be finalised in April 2018.

 

Action: Ms Bowie

11.20am

9.

Hospital Discharge Inquiry - 6 month recommendation monitoring pdf icon PDF 497 KB

The Health & Adult Social Care Select Committee carried out a review of the Hospital Discharge process and made recommendations to help improve the process across the whole health and social care system.  The final report went to the Council’s Cabinet in April and this item is an update on the progress of the recommendations at 6 months.

 

Attendees:

Debbie Richards, Director of Commissioning & Delivery, Clinical Commissioning Groups

Suzanne Westhead, Service Director (ASC Operations), Bucks County Council

Neil McDonald, Chief Operating Officer, Buckinghamshire Healthcare NHS Trust

 

Papers:

Six month recommendation progress table

 

Intended outcome:

For Members to discuss the progress on the recommendations and to delegate the assigning of the RAG status to the Chairman of the Committee.

 

 

Additional documents:

Minutes:

The Chairman welcomed Ms D Richards, Director of Commissioning & Delivery (Clinical Commissioning Groups), Ms S Westhead, Service Director (ASC Operations) and Mr N Macdonald, Chief Operating Officer (Buckinghamshire Healthcare NHS Trust).

 

The presenters took Members through the recommendations made in the Inquiry report and provided an update on each one.

 

Members noted the following key points:

 

·         Recommendation 1a – by April 2018, mental health services and the 111 operators would also access information on the "My Care Record";

·         Recommendation 1b – Health & Adult Social Care had agreed a "Discharge to Assess" model which would be implemented in December 2017.

·         Recommendations 1c and 1d – the National Inpatient Survey included questions around Hospital Discharge.  A Member asked for information about the workshops.  Mr Macdonald agreed to confirm the date and details on how participants were chosen.

Action: Mr Macdonald

 

·         Recommendation 1f – there were significant clinical vacancies in the Community Healthcare services team.  As the priority was on a safe transition of the service there would be no move to 7 day assessments at present.

·         Recommendation 1h – TTOs (To take-out medication).  Members were pleased to hear that key members from all disciplinary teams have co-designed a new process for the rapid completion of TTOs to include:

·         Pharmacy providing consistent ward cover, and the IT systems had changed to allow pharmacists to pre-write TTOs – this was launched on 15 November in the acute assessment wards;

·         A significant increase in pre-prepared TTO packs;

·         Medical ward rounds standardised so one member of the team was allocated to support the TTO process early in the morning.

 

RESOLVED:

The Committee AGREED to delegate assigning a RAG status to each recommendation to the Chairman of the Committee.

 

ADDENDUM:

Following the meeting, a revised recommendation response was received.  Attached is the updated version.

11.50am

10.

Adult Social Care Transformation pdf icon PDF 174 KB

The purpose of this item is for Committee Members to receive an update and to question the progress of the transformation project that is currently underway in Adult Social Care.

 

Attendees:

Denise Porter, Interim Director for Adult Social Care Transformation

 

Papers:

Presentation attached

 

Intended outcome:

For Members to understand the progress that has been made and to challenge the work of the project.

Additional documents:

Minutes:

The Chairman welcomed Ms D Porter, Head of ASC Transformation.

 

During the discussion, the following main points were raised and questions asked.

 

·         In response to a question about what was meant by "a different type of conversation", Ms Porter explained that it was about focussing on a person’s strengths and looking at what they can do rather than want they cannot.

·         As part of the transformation process, there were a number of work streams, including prevention, integration, market shaping & working with providers and whole life disability.  The work streams were supported by experts who were responsible for quality assurance, expert advice and implementation.

·         In response to a question about why the Director of Public Health was not on the Transformation Board, Ms Porter explained it was the intention not to make the Board too officer heavy.  Directors were involved in all the relevant Board discussions and instrumental to its success.

·         Ms Porter confirmed that learning had taken place from across the system to inform the transformation plans.

·         In response to a question about the financial robustness of using partners, Ms Porter confirmed that this was vital and it sits within each of the work streams.

·         A Member asked for clarification of the role of the District Council officer’s on the Board.  Ms Porter agreed to supply this information after the meeting.

Action: Ms Porter

 

·         In response to a question about whether the Transformation Board minutes were publicly available, Ms Porter said she would look into this but confirmed that the work of the Board was discussed with the relevant Cabinet Members and the feeds into the work of the Health & Wellbeing Board.

 

Action: Ms Porter

12.35pm

11.

Child Obesity Inquiry pdf icon PDF 306 KB

For Committee Members to discuss and agree the scoping document for the Child Obesity Inquiry.

 

Papers:

Draft scoping document

Additional documents:

Minutes:

Members discussed and agreed the draft scoping document for the Child Obesity Inquiry.  The membership was agreed and a private briefing for the Inquiry Group would take place after the next Committee meeting on Tuesday 30th January.

12.45pm

12.

Response to Developing Care in the Community pilot pdf icon PDF 438 KB

At the last Committee meeting, Members received an interim report on the progress of Buckinghamshire Healthcare NHS Trust’s "Developing Care in the Community" pilot.  The Committee agreed to set-up a Task & Finish Group to review the report and make recommendations for the Trust to consider in advance of preparing the final report in 2018.

 

Papers:

Task & Finish Group’s draft response to Buckinghamshire Healthcare NHS Trust’s "Developing Care in the Community"

 

Intended outcome:

For Committee Members to discuss and agree the draft response.  The final response will then be sent to the Hospital Trust.

 

Additional documents:

Minutes:

Members discussed and agreed the draft response to the "Developing Care in the Community" pilot.

 

RESOLVED:

The Committee AGREED to send the final response to representatives at Buckinghamshire Healthcare NHS Trust.

12.55pm

13.

Committee Work Programme pdf icon PDF 15 KB

For Committee Members to note the work programme.

 

Papers:

Work programme attached

Additional documents:

Minutes:

Members noted the work programme and agreed the following items for the January meeting.

 

·         Public Health;

·         Dementia Services.

1pm

14.

Date and Time of Next Meeting

The next meeting is due to take place on Tuesday 30 January 2018 at 10am in Mezzanine Room 1, County Hall, Aylesbury.

Additional documents:

Minutes:

The next meeting is due to take place on Tuesday 30th January 2018 at 10am in Mezz Room 1.