Agenda and minutes

Apologies for absence were received from Councillor Clayton.

Apologies for absence also were received from Councillor Naylor as, although not a member of the Committee, he attended regularly in his capacity as Lead Member for Health and Community Safety.

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.

Councillor Bayford declared a personal interest in 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, in that 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 9 February 2011 have been circulated and Members are asked to confirm them as a correct record.

The minutes of the meeting held on 9 February 2011 were approved 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 Director of Communications at NHS Leicester City presents a report on NHS Leicester City’s tendering process to increase community based beds in the City.

Jo Yeaman, (Project Director working for Primary Care Trusts in Leicester, Leicestershire and Rutland), presented a report on NHS Leicester City’s tendering process to increase community based beds in the City.  The Committee noted that this report had been approved at the NHS Leicester City and NHS Leicestershire County and Rutland Board Meeting on 10 March 2011.

Jo Yeaman explained that, typically, patients needing intermediate care beds were over 65, but this was not a requirement.  There were three types of intermediate care beds, so patients went in to them with a very clear care plan:-

·            To avoid admission to hospital:  These tended to be used by elderly, frail patients who were experiencing some kind of crisis, but which was not acute enough to lead to them being admitted to hospital, (for example, when help was needed in managing a condition);

·            For patients who had been in hospital:  These were used by patients who were medically fit, but needed more care before they went home; and

·            Rehabilitation:  These were the most used type of intermediate care beds.  Patients were able to learn new skills that enabled them to look after themselves at home.

It was acknowledged that there could be better outcomes for patients if there was better access to intermediate care, so a target of having 57 intermediate care beds had been set.  There currently were 27 in the City, which were spot-purchased, (ie, as needed), from Brookside (for hospital avoidance) or Clarendon Mews (for rehabilitation).  The 18 beds in the County were located across various hospitals.

It was proposed to increase the number in the City by 12.  It had been suggested that Leicester General Hospital would be the most appropriate place to have these beds, but the accommodation there was not right to enable patients to be rehabilitated effectively.  This option had not been rejected, but had been put on hold.  Different types of staff were needed for the different types of intermediate care beds, so if all of the beds were in one unit the staff could be deployed where they were needed.

An advertisement would be released on 30 March 2011, inviting expressions of interest.  It was hoped that the new arrangements could be in place in time to deal with the increased pressures experienced over winter periods, to ensure there was no service disruption.  Some suppliers could need a longer time to prepare beds, (for example, if they were a new supplier), but until options had been identified, it would not be possible to do a risk assessment.  Jo Yeaman offered to bring this assessment to the Committee when it was complete.

The following points were made in response to questions from Members:-

·            People typically stayed in an intermediate care bed for a maximum of between four and six weeks.  However, in the City a lot of beds were for rehabilitation purposes, from which people moved on in approximately two weeks;

·            The provision of additional beds would reduce delays currently experienced  ...  view the full minutes text for item 71.

Further to recent media coverage of the care received by elderly patients in local hospitals, the Committee is invited to consider:-

a)   the issues raised; and

b)   the complaints procedure used by local hospitals and how this is monitored.

Representatives of University Hospitals Leicester and NHS Leicester City have been invited to attend the meeting to assist the Committee in the scrutiny of these matters and to provide performance information on the care that elderly patients receive in hospital.

The Chair welcomed the members of the public who had attended the meeting for this item.  He indicated that he was willing to let a few of these people speak to the meeting, but would not let the item be debated for too long.  He also stressed that the Committee was not able to discuss individual cases.

Carole Ribbins, (Director of Nursing, University Hospitals of Leicester NHS Trust), gave a presentation on Older People’s Care, a copy of which is attached at the end of these minutes for information.

The meeting was reminded that there had been a campaign in the Leicester Mercury over recent weeks regarding patient care, and particularly that of the elderly.  97% of patients reported that they had had a good experience with the NHS, but this meant that 3% had not.  These situations were taken very seriously and the issues identified addressed.  To help in this, key targeted interventions had been examined a few years ago, in order to change staff behaviour, so that it became second nature to provide the best care possible.

Carole Ribbins drew particular attention to the following points:-

·            An interactive training module had been developed, which encompassed the fundamental things that needed to be at the heart of patient care.  All nursing staff went through this and a 100% pass rate was expected;

·            Extra hourly ward rounds by a designated nurse for every patient had been introduced in the United States of America in recent years, as a supplement to care.  The experience of patients and their relatives had improved as a result of this and staff stress levels had reduced.  Following its introduction in Leicester, other hospitals in the East Midlands also were considering introducing it;

·             “Nurse in Charge” badges had been used in the Accident and Emergency Department for some time.  This had been extended to wards for elderly patients in the last few weeks and had received very positive feedback;

·            It was planned to introduce large red badges for Matrons;

·            Data was collected from many different sources, but this could result in conflicting reports and sometimes did not give the whole picture of a situation.  It therefore was proposed to include information such as complaints and compliments, and feedback from staff and patients in data analysis;

·            It was important to celebrate and recognise good role models amongst staff, but it was equally important to recognise when staff were not working to expected standards of care;

·            The roll-out of the proposed interventions would be done in conjunction with other work, such as that being done in dementia care; and

·            The University Hospitals of Leicester NHS Trust was committed to making the changes needed to make poor patient experience a thing of the past.

Caroline Trevithick, (Deputy Director of Quality, NHS Leicester City), then briefed the Committee on the Care of Older People.  A copy of her presentation is attached at the end of these minutes for information.

Caroline Trevithick drew particular attention to the following points:-  ...  view the full minutes text for item 72.

The Director of Finance with NHS Leicestershire County and Rutland will make a presentation on the Primary Care Trust Strategic Operating Plan, setting out its investment and disinvestment priorities for the year ahead, its approach to dealing with the financial challenges facing the local NHS and managing the transition to future arrangements as set out in the Health Bill.

Sue Bishop, (Director of Finance with NHS Leicester City, Leicestershire County and Rutland), tabled an updated version of the presentation on the 2011/12 Strategic Operating Plan (SOP) and Financial Plan that had been circulated with the agenda.  A copy of this is attached at the end of these minutes for information.

Sue Bishop drew particular attention to the following points:-

·            The 2011/12 operating framework was issued in December 2010.  The main themes of this were transition and reform, transparency and local accountability, and service quality;

·            Part of the dis-establishment of primary care trusts involved moving some services to local authorities and some to national provision, (for example, specialist services would be focussed in a small number of units around the country).  The proposed GP consortia would be nearer to the patients, so would have a greater understanding of their needs;

·            The City, county and Rutland areas all had very different health needs.  This was recognised in the Plans and underpinned what it was expected would be delivered during 2011/12;

·            The areas for improvement had been identified nationally.  The underlying theme of these was the protection of vulnerable groups in the population;

·            Locally, an additional £44 million of funding had been agreed to protect services.  This equated to approximately 3% of the budget.  Just under £564 million was available to spend across Leicester City;

·            Incentives for health and social care services to work together would be provided through the Plans.  In this way, it was hoped to increase social support and reduce hospital admissions and readmissions.  To assist with reducing readmissions, approximately £10 million had been made available for re-ablement services;

·            Just over £28 million had been set aside for service transformation.  Advances in technology and treatments meant that it now was possible to treat patients to a more complex level, so the way in which services were provided needed to change.  Under the current Plans, it was expected that a surplus of just under £10 million would be generated, which could be used to fund services in future years;

·            The SOP was supported by the newly emerging GP consortia and had been submitted to the Department of Health for approval.  It was expected that this would be received in the next few weeks.  Consultation would be undertaken if needed before it was implemented;

·            QIPP was a programme created nationally, but delivered locally, to improve Quality, Innovate, gain Productivity and achieve the Prevention of disease; and

·            Challenges and risks had been identified, to ensure that things that would make the biggest difference to the public remained the main focus of the Plans and that clinical engagement was maintained.

The following points were made discussion on this item:-

·            There was a need to ensure that quality services were delivered.  Sue Bishop confirmed that more was being required from fewer resources. This was helped by the quality of data available, as this helped in making more accurate comparisons and benchmarking against other areas;

·            In many parts of the country, respiratory disease  ...  view the full minutes text for item 73.

The Annual Report of the Director of Public Health and Health Improvement 2010, “Improving Health in Leicester”, is presented to the Committee for scrutiny.  The Committee is recommended to consider the report and comment as appropriate.

The Director of Public Health and Health Improvement 2010 presented the Annual Report of the Director of Public Health and Health Improvement 2010, “Improving Health in Leicester”.

The Committee welcomed this report, recognising the importance of the matters reported on, and

RESOLVED:

that the Annual Report of the Director of Public Health and Health Improvement 2010 be noted.

The Members’ Support Officer submits a document that outlines the Health Scrutiny Committee Work Programme for the municipal year 2010/11.  The Committee is asked to consider the programme and make comments and/or amendments as it considers necessary.

RESOLVED:

thatthe Health Scrutiny Committee Work Programme for the 2010/11 municipal year be noted.

future of east midlands congenital heart centre (EMCHC)

The Chair agreed to accept this item as urgent business, as there was a fixed period of consultation on proposals for the future of the EMCHC, but due to the forthcoming elections it was not known when this Committee’s next meeting would be held.

The Committee was reminded verbally that the NHS recently had launched a major consultation on the way in which children’s congenital heart services should be provided in the future.  The outcome of this would determine the future of the EMCHC, which was based at Glenfield Hospital.  Members therefore were asked to support the retention of the Centre, which featured as Option A of the consultation.

The Committee expressed its support for the statement made at the Council meeting on 24 March 2011 by the Lead Member for Health and Community Safety in favour of keeping the Centre at Glenfield Hospital.

The meeting closed at 8.52 pm