Agenda and minutes

Although only two members of the Committee were present at 6.00 pm, it was decided that the meeting should proceed on an informal basis.

Apologies for absence were received from Councillors Blackmore, Cooke and Hall.

Members are asked to declare any interests they may have in the business on the agenda, and/or indicate that Section 106 of the Local Government Finance Act 1992 applies to them.

Members were asked to declare any interests they had in the business on the agenda and/or declare if Section 106 of the Local Government Finance Act 1992 applied to them.

Councillor Bayford declared a personal interest, in relation to the general business of the meeting, in that his wife was a salaried GP, although she was not a partner in the practice.

Councillor Manjula Sood declared personal interests, in relation to the general business of the meeting, as she was a patron of CLASP, the Chair of the Leicester Council of Faiths and an ambassador for the East Midlands for Sporting England.

The minutes of the meeting held on 4 February 2010 have been circulated and the Committee is asked to confirm them as a correct record.

RESOLVED:

that the minutes of the meeting of the Health Scrutiny Committee held on 4 February 2010 be confirmed as a correct record.

The Director of Corporate Governance to report on the receipt of any petitions submitted in accordance with the Council’s procedures.

The Director of Corporate Governance reported that no petitions had been received.

The Director of Corporate Governance to report on the receipt of any questions, representations and statements of case submitted in accordance with the Council’s procedures.

The Director of Corporate Governance reported that no questions, representations or statements of case had been received.

The Head of Planning and Commissioning, Personalisation and Business Support Division, will submit a report that advises of the purpose and remit of the Leicester City LINk, and the host organisation, which supports the work of LINk.  The Committee is recommended to note the contents of this report and the proposal of the LINk to give a presentation of their work to a future meeting.

The Head of Planning and Commissioning (Leicester City Council), submitted a report that advised the Committee of the purpose and remit of the Leicester City Local Involvement Network (LINk), and the host organisation that supported the work of LINk.  The Committee welcomed Daryl Hines and Zuffar Haq, Co-Chairmen of Leicester City LINk, and the Head of Planning and Commissioning, to the meeting.

Members noted that Leicester City LINk currently was reviewing the outcomes of its work during 2009/10 and proposed to report these findings to this Committee, possibly in May 2010.  It was hoped that the LINk’s work programme for 2010/11 could be considered at the same time.  The Committee noted that most LINk organisations took approximately one year to become established and this had been the case for Leicester City LINk. 

The LINk was a network of interested individuals and organisations, with the Carers Federation in Leicester acting as host organisation and providing administrative support.  LINks had the right to talk to any commissioners of health services and enter premises to inspect services.  In this way, they held the health authorities to account for the services they provided. 

Zuffar Haq explained that LINk spoke to experts on particular areas of interest and held public meetings around the City to seek views on these matters.  During 2009/10 public meetings had been held on diabetes, dementia and healthy eating.

Information at these meetings was presented in a simple, straightforward style, so that the public remained engaged with the discussion.  This approach appeared to have been successful.  For example, a lot of advice had been provided at the meetings that was not always readily available from GPs, sometimes due to time constraints, and issues identified at these meetings were followed up at later meetings.  The Primary Care Trust (PCT) was in constant dialogue with the LINk and came to its meetings and so became aware of problems as they were identified.

Councillor Gill arrived at the meeting at 6.14 pm, at which point the meeting became quorate.

The Head of Planning and Commissioning advised the Committee that the future of the LINk was not certain.  Although each area was statutorily required to have a LINk, their funding was only guaranteed until March 2011.  No indication had been given by the government of whether funding would continue after that date.

There was some discussion about the uptake of health care services in some sectors of the population, particularly amongst the elderly.  Zuffar Haq advised the Committee that the first public debate hosted by LINk had been on dementia and people with particular interest in that area were on the Board of LINk.  Diabetes also had been discussed at one of LINk’s public meetings.  In addition, care for the elderly, and its provision, had been targeted in the LINk’s work, (for example, criteria for patient transport services, which could be a problem for elderly people who needed help with transport).

Daryl Hines reported that Leicester City LINk had undertaken a survey, through the Leicester  ...  view the full minutes text for item 64.

David Riley, Head of Primary Care Improvement with Leicester City Primary Care Trust, submits a paper updating the Committee on the introduction of a Balanced Scorecard and the progress made so far in the Annual Quality Review programme, together with key themes, areas of learning and next steps in this annual cycle.  The Committee is recommended to consider this report and comment as appropriate.

David Riley, Head of Primary Care Improvement with Leicester City Primary Care Trust (PCT), submitted a paper updating the Committee on the introduction of a Balanced Scorecard and the progress made so far in the Annual Quality Review programme, together with key themes, areas of learning and the next steps in this annual cycle. 

David Riley drew particular attention to the following:-

·              One element of the annual cycle of quality was the production of annual quality plans for general practice.  This, and the Balanced Scorecard, were benchmarking practices;

·              An example of a populated Balanced Scorecard was tabled at the meeting and is attached at the end of these minutes for information.  It was hoped that this would eventually be updated monthly.  The possibility of automating the Scorecard was being investigated.;

·              A national Patient Experience Survey had been undertaken, to which 16,000 responses had been received.  These results were taken very seriously and, when put with other data, such as that from the census, gave a clearer picture of the City;

·              Each GP practice was now part of the programme of annual review visits.  To date, 59 had been visited and a further 4 would be visited before mid-April 2010.  Each practice had specific areas that needed to be developed.  When GPs had more than one practice, each was treated as a separate practice and visited accordingly;

·              Leicester City PCT was very poor in terms of patient satisfaction, but the introduction of these measures meant that GPs could now see how each practice was rated;

·              As well as benchmarking, a “traffic light” system of rating also was used.  The PCT worked very closely with practices receiving a red rating to improve service quality.  However, if improvements could not be made, contractual remedies would have to be considered, such as the issue of notices to improve;

·              The information gathered through the Annual Quality Review programme was considered by a Quarterly Review Team, which comprised of high-level officers and contractor input.  The results of the review were fed to the practice concerned and the Balanced Scorecards became part of the that practice’s quarterly review plans;

·              The results of the review also would be made available soon to the general public, for example when looking to change GP practice.  At present, discussions were being held on whether it should be included on the national promoting NHS choices website and, if so, how it should be presented; and

·              The results obtained from these reviews needed to be matched to other data, for example the number of complaints received about a practice.

During discussion on this, the Committee noted that other PCTs did not appear to be publishing data on quality of GP services.  David Riley explained that practices were being categorised, so that differences in quality between apparently similar practices could be seen, (for example, as shown through comparing satisfaction surveys).  Tim Rideout, Chief Executive of Leicester City PCT, undertook to give further consideration to the publication of this data, as one way of helping  ...  view the full minutes text for item 65.

Toby Sanders, Director of Primary Care with Leicester City Primary Care Trust, will make a presentation on the new management arrangements for Leicester City Primary Care Trust and Community Services.

Tim Rideout, Chief Executive of Leicester City Primary Care Trust (PCT), tabled a report on the organisational form and direction of travel of PCT provider services, a copy of which is attached at the end of these minutes for information.

Tim Rideout explained that the government’s current view was that the PCT should commission, not provide, health care.  This had been embodied in guidance issued on 5 February 2010, as explained in the Summary of the report attached.  As was also set out in that paper, the Leicester City PCT and the Leicestershire and Rutland PCT were working together to determine future arrangements for their community services. 

Proposals for the integration of the services were set out in the report, from which it was noted that only a very small group of services would be retained by the PCT, in view of its new commissioning focus.  The Committee noted that, as the proposed direction of travel had been accepted by the two PCT Boards and had been considered by the Leicester, Leicestershire and Rutland Joint Health Overview and Scrutiny Committee, the next stage was to undertake detailed testing of the proposed direction of travel.  Following this, the proposals would be put out for public consultation and subsequent implementation by the end of March 2011.

In response to a question from the Committee, Tim Rideout explained that the success of these proposals would depend on the quality of commissioning of the services, including how the new providers of the services would be held to account.

Zuffar Haq, Co-Chairman of the Leicester City Local Involvement Network, asked why the services had to be provided at arms length through a separate organisation.  He further stated that this appeared to be a very quick change in the way services were provided and expressed the concern that these changes would make them easy services to cut in times of financial restraint.

In reply, Tim Rideout explained that an arms-length body had been established in January 2008.  The possibility of establishing a large Health and Social Care social enterprise had been considered, but the government’s rules precluded this option and it was recognised that it would have had a high cost for low patient benefit.  The options presented for consideration therefore were felt to be the best way forward, although it was recognised that the situation could change depending on which political party, or parties, came to power following the forthcoming General Election.

Zuffar Haq expressed concern that the new proposals would result in people who currently could be treated in the community having to go in to hospital.  This could result in people not receiving care as quickly as they did at present and could be a lot more expensive for the PCT.  Tim Rideout stressed that the investment and focus on services would not be reduced, as the Boards of both PCTs and the Trusts were committed to high quality services.

RESOLVED:

                        1) that the recent national guidance and the implications for Primary Care  ...  view the full minutes text for item 66.

Toby Sanders, Director of Primary Care with Leicester City Primary Care Trust, will give a verbal update on the NHS Local Improvement Finance Trust (LIFT) project.

Sarah Cooke, Associate Director (Corporate Performance) with Leicester City Primary Care Trust (PCT), gave a verbal update on the NHS Local Improvement Finance Trust (LIFT). 

In addition to several practices having opened in the last year, the De Montfort University practice was relocating from its current campus site to a new building on Millstone Lane, next to the Queens building.  Construction of this was scheduled to end on 11 April 2010.  This practice would open in May 2010. 

Construction of the Belgrave practice would start in June 2010 and currently was scheduled for completion in August 2011.  It would be built in Brandon Street, on the site of a former adventure playground.  Various services would be brought together at this practice, which would use a shared reception and administration service, but which would have their own treatment rooms.  The design of the practice took in to account the considerable housing development work forecast for the Belgrave area, having capacity to take additional patients over the years.

Sarah Cooke advised the Committee that:-

·              the PCT had invested approximately £3.5 million in its own health centre stock over the last few years;

·              approximately £600,000 had been given in financial support to smaller projects, such as the development of general practices that owned their own buildings; and

·              the PCT had a Fit for Purpose programme for the practices with the most challenging issues.  Currently, 19 practices were on this programme, 8 of which were seeking to rebuild their practice accommodation.  The most challenged of the practices on the programme received assistance first.

Zuffar Haq, Co-Chairman of the Leicester City Local Involvement Network, commented that, following the investment in smaller projects:-

·              what improvement in patient care was expected?;

·              the opportunity could be taken to stop GPs charging to write doctors’ letters; and

·              “payback” from GPs in the form of no longer using 0844 telephone numbers would be welcomed.

Sarah Cooke confirmed that a number of measures were used to promote improved services to patients, but the PCT had to be measured in the approach it took.

The Members’ Support Officer submits a document that outlines the Health Scrutiny Committee Work Programme for the municipal year 2009/10.  The Committee is asked to consider the programme and make comments and/or amendments, as it considers necessary.

RESOLVED:

1)           that the Committee’s Work Programme for 2009/10 be noted;

2)           that the issues of access to maternity services in Leicester and teenage pregnancy be considered as separate subjects, not as themes within the proposed Focus on Health Inequalities; and

3)           that the new Cabinet Lead for Health and Community Safety be invited to provide the Committee with an overview of his role.

The meeting closed at 8.03 pm