Agenda and minutes

Apologies for absence were received from Councillor Desai.

Members are asked to declare any interests they may have in the business to be discussed.

Members were asked to declare any interests they might have in the business to be discussed.  No such declarations were made.

The minutes of the meeting held on 3 September 2013 have been circulated and the Commission will be asked to confirm them as a correct record.

The minutes can be found on the Council’s website at the following link:-

http://www.cabinet.leicester.gov.uk:8071/ieListDocuments.aspx?CId=737&MId=5925&Ver=4

RESOLVED:

that the minutes of the meeting held on 3 September 2013 be approved as a correct record.

The Monitoring Officer to report on the receipt of any petitions submitted in accordance with the Council’s procedures.

The Monitoring Officer reported that no petitions had been submitted in accordance with the Council’s procedures.

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

The Monitoring Officer reported that no questions, representations or statements of case had been submitted in accordance with the Council’s procedures.

The Members Services Officer submits a document that outlines the Health and Community Involvement Scrutiny Commission’s Work Programme.  Commission is asked to consider the Programme and make comments and/or amendments as it considers necessary.

The Scrutiny Support Officer submitted a document that outlined the Health and Wellbeing Scrutiny Commission’s Work Programme for 2013/14.

The Chair reported that the Work Programme would not be fully finalised until the current external scrutiny review had been completed.  However, the following items would be added to the Work Programme for the November meeting:-

a)    Update on Progress on ‘Closing the Gap’ (Leicester’s Joint Health and Wellbeing Strategy 2013-2016).

b)    Bradgate Adult Mental Health Unit – review of 2^nd inspection by the Care Quality Commission and progress.

c)    Public Health Budgets.

d)    Dental Health in the City and Dental Health Strategy and Policy.

e)    Response to the Commission’s Scrutiny Reviews. 

The Commission is recommended to note the items that are relevant to its work in the Corporate of Key Decisions that will be taken after 1 October 2013.

The Commission received and noted the items that were relevant to its work in the Corporate of Key Decisions that will be taken after 1 October 2013.

The Chair stated that there was nothing on the current Corporate Plan that affected the Commission.  There were some items that were relevant to the Adult Social Care Scrutiny Commission, which could involve Commission members if joint scrutiny was undertaken.

A Member questioned why there were no Key Decisions on the Corporate Plan relating to health issues in the City.  The Deputy City Mayor stated that the current lack of items in the Plan should not be seen as an indication that health matters were seen as being important.  When the responsibility for public health transferred to the City Council in April 2013, most of the existing commissioning arrangements were extended for a year to enable the Council to review the position in relation to the budget and to enable the Council to determine its priorities for health and wellbeing provision.  Once these priorities had been determined through the budget process, items would begin to appear in the Corporate Plan as changes were made to commissioning arrangements.

A Member asked that arrangements for providing training for cardiopulmonary resuscitation (CPR) in schools be considered as part of the future priorities.

Professor David Chiddick, Chair of the Leicestershire Partnership Trust (LPT), Dr Satheesh Kumar, Medical Director, LPT, and Cheryl Davenport, Director of Business Change, LPT will attend the meeting to provide an update on the measures taken in response to the Care Quality Commission’s Notices issued in relation to the Bradgate Unit.

Following consideration of the LPT’s report at the last meeting position statements have been requested from other relevant bodies as listed below:-

Care Quality Commission                                                              Appendix D

NHS England                                                                                   Appendix E

Leicester City Clinical Commissioning Group                           Appendix F

A recent article in the Leicester Mercury on 24 September is also attached at Appendix G for information.

Professor David Chiddick, Chair of the Leicestershire Partnership Trust (LPT), Dr Satheesh Kumar, Medical Director, LPT, and Cheryl Davenport, Director of Business Development, LPT attended the meeting to provide an update on the measures taken in response to the Care Quality Commission’s Notices issued in relation to the Bradgate Unit.

The Director of Business Development introduced the report which updated the Commission on the Trust’s progress in responding to the Care Quality Commission’s (CQC) report and also in relation to the development of the Trust’s Quality Improvement Programme. (QIP)  The QIP was intended to be finalised by 31 October 2013, and contained a number of themed actions beyond the immediate 30 day action plan outlined at the last meeting.  The CQC had made a further visit in September 2013 to assess the progress made by the Trust in relation to the areas of concern contained in the two warning notices.  The Trust believed it had made improvements but was currently awaiting the CQC report on the second visit.  A draft report for factual checking was expected later in the week and the final report was expected to be published in November.  The Trust also provided details of the following in their report:-

a)    A summary of the NHS England Risk Summit in August.

b)    Details of the roles and responsibility of the Oversight and Assurance Group, an advisory body set up by the Trust Development Authority, to collectively share intelligence and support the Trust to ensure that they become a sustainable quality organisation.

c)    The Governance structure and themed work streams for the QIP.

d)    A response to the Commissions’ concerns raised earlier in the year in relation to Leicester LINk’s Enter and View Report submitted to the Commission’s meeting on 9 April 2013 (Minute 125 b) - refers).  The points raised at that time were all being addressed in the QIP. A number of meetings have been held with mental health organisations and the two acting chairs of Healthwatch to discuss the issues and make improvements for the future.

The Trust had consulted local authorities, the three CCG’s, the Trust Development Authority, the Voluntary Sector, Healthwatch and patient groups on the QIP.  The Trust were meeting again in two weeks to consider the feedback on the QIP and comments were welcomed on the QIP until 23 October.

The QIP demonstrated how the Trust were taking action to improve quality.  The issues were not just restricted to improving quality in the Adult Mental Health Division but they also affected other health divisions within the Trust.  Measures already put in place were:-

a)    A situation reporting matrix;

b)    A number of improvements for the crisis and home treatment service, which are shown in detail in the QIP, were being put in place;

c)    Monitoring of overall bed capacity, which was not just isolated to Leicester and the use of Step Down and Crisis House facilities to reduce the pressures on beds where appropriate;

d)    The appointment of the Chief Nursing  ...  view the full minutes text for item 68.

To receive an update report on the NHS 111 service.  The update will be provided by a representative of the Leicester City Clinical Commissioning Group.

Tony Menzies, Leicester City Clinical Commissioning Group provided an update on the roll-out of the NHS 11 service across Leicester, Leicestershire and Rutland. 

The NHS 111 service provided by Derbyshire Health United went live on 9 September 2013 and anyone dialling ‘111’ was connected direct to the service.  The following day NHS Direct was made unavailable in Leicester, Leicestershire and Rutland and callers were re-directed by a voice message to call ‘111’.  On 24 September GP practices in West Leicestershire CCG began the process of directing patients to the NHS 111 service for out of hours service.  The performance of the service between 9-22 September was monitored and 98.46% of the 2,481 calls were answered within 60 seconds.

GPs in the East Leicestershire CCG would transfer their out of hours calls to the ‘111’ service on 23 October 2013 and the GPs in the City CCG were due to transfer out of hours call on 5 November.

Members were informed that the performance of the service was monitored daily by tele-conference,  involving the three CCGs, the clinical lead, GP out of hours service and clinicians from other urgent care services.   There was also weekly clinical review meeting every week with clinicians from the urgent care services for all three CCG areas. 

Members questioned whether the 5 November was realistic for the City out of hours switch over, given that it was within the Diwali festivities and also Bonfire Night which traditionally led to increased volumes of calls, particularly as the switch over had been delayed by a week due to a ‘minor performance issue’.  Members also asked further questions of the service provision.

The Healthwatch representative reported that an impact assessment had been requested from Derbyshire United Health and a short response had been received.  A full impact assessment had then been requested to indicate how the service intended to reach different patient groups in the three CCG areas, especially where English was not the first language.  A response was awaited.

In response it was stated that:-

·         A local equality impact assessment had been carried out locally and Mr Menzies agreed to share it with the Commission and Healthwatch;

·         The service did provide a full translation service for users;

·         The decision to delay the roll-out by a week had been based on a three hour period one Saturday morning when performance fell 1% short of the required standard of 95% of calls being answered in 30 seconds.  This had been due to a high level of absence and an IT/Operational issue.  Performance had been satisfactory since then.  The decision to delay the roll-out had been based on extremely cautious approach and the service was now confident it could deal with the expected volume of calls.

RESOLVED:

1)    that the update report be received and noted;

2)    that the CCG submit the local equality impact assessment to the Commission’s next meeting and to Healthwatch;

3)    that performance and complaints data together with a further update on the implementation  ...  view the full minutes text for item 69.

Paul Leonard Williams, Disabled Access Officer will present the report and give a short presentation on the overall strategy and policy for Access for All and will give specific examples relating to health and wellbeing.

Paul Leonard Williams, Disabled Access Officer presented the report and gave a short presentation on the overall strategy and policy for Access for All and gave specific examples relating to health and wellbeing. A copy of the presentation is attached to these minutes for information.

During the presentation the following were outlined for Members information:-

·         The main aim of the policy was to ensure that principles of inclusive design were achieved so that places and products could be accessed easily, safely and with dignity by everyone.

·         The policy also wanted to promote getting design decisions right first time so that there was no need to ‘retro-fit’ in the future incurring additional expenditure;

·         The ‘Think Links’ element of the policy was aimed at providing good information and awareness of systems and processes, to provide good access to services etc.;

·         Good functional design elements also needed to be balanced with aesthetics, robustness and ‘fit for purpose’ functions;

·         The removal of street clutter was also important to allow people to freely access health and wellbeing service and facilities, whether these were leisure or functional in nature.  For example access to recreational spaces or chemists, health centres and GPs surgeries with adequate access and parking etc.  There were examples of health surgeries where long queues developed through people wishing to make appointments because the telephone booking system did not cope with the volume of patients;

·         There was also a need to plan bus services to integrate with health service provision;

·         Street works also had an impact on health and wellbeing as a result of the cost to individuals of slips trips and falls and accidents involving cyclists etc.;

·         The provision of open spaces and shade in the design of schemes was also important to health in allowing people to sit and rest in shade when this was required;

Members welcomed the presentation and felt that the importance of this work was not fully appreciated within all the Council’s services.  There were capacity and procedural issues arising from the report which had cross-cutting implications for cultural changes to service provision throughout the Council, and Members felt these issues should be reported back to the Overview Select Committee, which had received the original presentation and had asked all Commissions to consider the implications of the policy on their work.  The principles of the policy were far reaching and Members felt that the Disabled People’s Access Officer could not be consulted or involved on all planning applications, major projects or process involving access to the Council’s services and facilities.       

RESOLVED:

that the report and presentation be received and that the Chair report the Commission’s comments back to a future Overview Select Committee to consider how the policy can be effectively be embedded into accessing Council services and also be incorporated into the planning, design and implementation of major schemes as well as ensuring that the planning process delivers the aims of the policy in each application it considers.

Rod Moore, Divisional Director, Public Health, and Nicola Hobbs, Head of Contracts and Assurance, Care Services and Commissioning to present a report on commissioning, contract management procurement arrangements for the public health responsibilities that were transferred to the City Council in April 2013.

Rod Moore, Divisional Director, Public Health presented a report on commissioning and contract management procurement arrangements for the public health responsibilities that were transferred to the City Council in April 2013.

Members noted that officers were working with the Deputy City Mayor to review the arrangements for commissioning services.  Details of existing contracts were attached to the report.  It was noted that whilst these were grouped under ‘providers’ the list could be provided to indicate contracts under specific ‘health themes’.  60% of the cash value of the total contracts had been re-commissioned.  Work was currently being undertaken to develop a realistic procurement plan so that all or large groups of contracts were not commissioned at the same time. 

RESOLVED:-

that the report be received and that the contracts be reviewed further at a future meeting and that the contracts also be presented under the grouping of specific health themes.

To receive an update on the progress of the Congenital Heart Disease Review.  The following documents are attached to provide Members with background information:-

Letter from NHS England to Councillor Cooke                          Appendix K

Response by Councillor Cooke to NHS England Letter          Appendix L

NHS England 6^th Update                                                               Appendix M

NHS England 7^th Update                                                               Appendix N

NHS England 8^th Update                                                               Appendix O

Notes of a Meeting between NHS England and the

Local Government Association and the Centre for

Public Scrutiny                                                                                 Appendix P

NHS England held a New Congenital Heart Disease Review: Board Task and Finish Group meeting on 30 September 2013.  The meeting considered a ‘Proposed Scope and Interdependencies’ document which is attached at Appendix Q.  The document outlines what NHS England already known about the review, as well as illustrating those areas where more work is needed before a judgement can be made.  In 1 October 2013, NHS England notified the Council that it planned to take questions about the scope of the review to the first meeting of the Clinical Advisory Panel on 15 October 2013 and asked for comments on the paper by 7 October 2013 so that these could be fed into the Panel’s meeting.  A copy of the paper was sent to Health Scrutiny Officers for Rutland County Council and Leicestershire County Council asking them to share it with their members and make any comments direct to the Congenital Heart Review Team by 7 October.

The Chair will provide an update on any further progress or developments which arise before the meeting.

Members received an update on the progress of the Congenital Heart Disease Review.  The following documents were submitted to Members for their information:-

a)    Letter from NHS England to Councillor Cooke       

b)    Response by Councillor Cooke to NHS England Letter   

c)    NHS England 6^th Update                                                                    

d)    NHS England 7^th Update                                                                    

e)    NHS England 8^th Update                                                        

f)     Notes of a Meeting between NHS England and the Local Government Association and the Centre for Public Scrutiny                                                                               

It was also noted that NHS England had held a New Congenital Heart Disease Review: Board Task and Finish Group meeting on 30 September 2013. The meeting had considered a ‘Proposed Scope and Interdependencies’ document which was also submitted for information.  The document outlined what NHS England already knew about the review, as well as illustrating those areas where more work was needed before a judgement could be made. 

NHS England has also notified the Council on 1 October that it planned to take questions about the scope of the review to the first meeting of the Clinical Advisory Panel on 15 October 2013 and asked for comments on the paper by 7 October 2013 so that these could be fed into the Panel’s meeting.  A copy of the paper was sent to Health Scrutiny Officers for Rutland County Council and Leicestershire County Council asking them to share it with their members and make any comments direct to the Congenital Heart Review Team by 7 October.  The Chair had sent a response on behalf of the Commission and copy of his reply was circulated to members at the Meeting.

The Chair also reported that the meeting with NHS England referred to in the correspondence at a) and b) above had been arranged for 25 October 2013 with scrutiny members from Leicester, Leicestershire and Rutland.  A separate meeting had also been arranged with the Executive members for the three authorities.

RESOLVED:-

                        that the update reports be received.   

Julie O’Boyle, Consultant Public Health, to present an update report on the Alcohol Awareness Campaign that was originally presented to the Commission at its meeting on 17 July 2103.

Julie O’Boyle, Consultant Public Health, presented an update report on the Alcohol Awareness Campaign that was originally presented to the Commission at its meeting on 17 July 2103.

Members noted that the last of the promotional events had taken place on the previous Saturday.

The report contained a number of outcomes for the campaign. A number of events had taken place since the report was written and the results were updated as follows to take account of all the events that had been held, except for the last one:-

·         3,050 people had now seen the event;

·         800 ‘We Are on Tour Flyers had been handed out;

·         350 people had completed the alcohol quiz;

·         Of these 200 people were drinking within safe limits and had been given ‘Well Done’ stickers and entered into a prize draw for recreational events;

·         15 people had scored highly and had been referred for further treatment;

·         150 people had signed up to the pledge and would receive discounts vouchers for activities in the City.  These people would be reviewed over the coming months to monitor their performance of the pledge.  The original aim was to have a cohort of 50 people signed up to the pledge.

Once the results of the Saturday event were known, there would be a full evaluation of campaign.

In response to Members questions on particular alcohol related problems and groups such as street drinkers in other wards not covered by this social awareness campaign, Julie O’Boyle stated that there were other measures available within public health measures to address these issues.   

RESOLVED:

that the evaluation of the campaign be submitted to the January meeting of the Commission together with a report on the whole public health alcohol strategy.

To receive an update report on the External Review ‘Fit for Purpose’ Health Scrutiny by Expert Advisor (Brenda Cook) Centre for Public Scrutiny.  The update also includes the notes of the first development session held on 18 September 2013.

Members received an update report on the External Review ‘Fit for Purpose’ Health Scrutiny by Expert Advisor (Brenda Cook) Centre for Public Scrutiny.  The notes of the first development session held on 18 September 2013 were also submitted to Members for information.

The Chair reported that Brenda Cook was unable to attend the meeting but work was progressing on the review and he had received a draft questionnaire on a training needs assessment for Members and this would be shared with Members in due course.

RESOLVED:

                        that the update report be received.

To review the responses received in relation to the Commissions’ Scrutiny Reviews of the ‘Mental Health Review for Working Age Adults in Leicester’ and the ‘Review of Voluntary and Community Sector Groups who raised concerns about Funding, Commissioning and Tendering issues’.

These reviews were completed in June 2013 and forwarded to the Executive and interested partners.  The Chair will provide an update on progress.

The Commission received an update on the responses received in relation to the Commissions’ Scrutiny Reviews of the ‘Mental Health Review for Working Age Adults in Leicester’ and the ‘Review of Voluntary and Community Sector Groups who raised concerns about Funding, Commissioning and Tendering issues’.  These reviews were completed in June 2013 and forwarded to the Executive and interested partners. 

The Chair stated that the two review reports had been issued to various interested parties but no responses had been received.  However, the Executive had invited the Chair to present the reports to them on 5 November and Members of the Commission had also been invited to attend.  The LPT and the CCG had also indicated that they would be submitting their responses to the next meeting of the Commission.

The Chair also reported that he had been appointed the Council’s Advocate for Mental Health.  This was part of a national initiative to raise the profile of Mental Health.  There were currently 11 Council Advocates for Mental Health in the country and a meeting had been convened on 2 December 2013 by the Centre for Mental Health.

RESOLVED:

that the update be received and that the responses be considered at the next meeting of the Commission.

The Chair to report on a proposed joint Scrutiny Review by the Commission and the Adult Social Care Scrutiny Commission on ‘Winter Planning For Health and Social Care Provision for Elderly and Vulnerable People in Leicester.’  A Draft Scoping Report is attached and will be considered at the Adult Social Care Scrutiny Commission at its meeting on 10 October 2013.  Any amendments to the draft made by Adult Social Care Scrutiny Commission will be reported at the meeting.

The Chair reported on a proposed joint Scrutiny Review by the Commission and the Adult Social Care Scrutiny Commission on ‘Winter Planning For Health and Social Care Provision for Elderly and Vulnerable People in Leicester.’  A Draft Scoping Report was submitted for Members’ consideration. The draft report had been considered at the Adult Social Care Scrutiny Commission at its meeting on 10 October 2013 and had been approved without amendment.

Members noted that Councillor Chaplin would be the Chair for the review and that meetings for the joint review had been arranged for 24 October, 14 November and 19 November at 5.30pm.  Councillor Chaplin stated that a visit to the Accident and Emergency facility at the Leicester Royal Infirmary was likely to take place on 8 November.

The Scrutiny Support Officer reported that the University Hospitals Leicester (UHL) NHS Trust and the Leicester City Clinical Commissioning Group had also submitted comments to widen the scope of the winter care arrangements.   Dr Freeman endorsed the view of the UHL NHS Trust that the winter care arrangements were not just about the frail and elderly or the A&E facility, but were also concerned about patient flows around all the hospital wards and patient discharge arrangements.

Councillor Chaplin confirmed that this would be form a topic of discussion at the first meeting.  The issue of talking to patients and carers directly was also recognised and would also be discussed at the first review meeting.

RESOLVED:-

that the terms of the scoping document for the joint review of the Winter Care Plan for Leicester be approved.

Verbal updates, as appropriate will be given on progress with any matters discussed at a previous meeting which are not being considered as a specific item on the agenda.

The Chair circulated a letter received from UHL on their consultation proposals for the emergency floor scheme and the relocation of outpatient clinics to the Leicester General Hospital, following the presentation to the last meeting of the Commission.

RESOLVED:

                        that contents of the letter be received for information.

a)     Health and Wellbeing Board

The minutes of the Health and Wellbeing Board meeting held on 11 July 2013 are attached at Appendix U.  The attachments in the minutes are not included.  These can be found at the following link:-

http://www.cabinet.leicester.gov.uk:8071/documents/g5648/Public%20minutes%20Thursday%2011-Jul-2013%2010.00%20Health%20and%20Wellbeing%20Board.pdf?T=11

Alternatively copies can be obtained from Democratic Services at the contact details shown in the ‘Information For Members of the Public’ section at the beginning of the Agenda.

b)     Being the Best

To receive a letter issued by the East Midland Ambulance Service NHS Trust on the progress with the Being The Best Review (Appendix V)

a)     Health and Wellbeing Board

The minutes of the Health and Wellbeing Board meeting held on 11 July 2013 were received for information.  The attachments in the minutes were not included, but could be found at the following link:-

http://www.cabinet.leicester.gov.uk:8071/documents/g5648/Public%20minutes%20Thursday%2011-Jul-2013%2010.00%20Health%20and%20Wellbeing%20Board.pdf?T=11

Members also noted the following reports that had been considered by the Board at its meeting:-

i)             Urgent Care Update

ii)            Healthwatch Update

iii)           Fulfilling Lives  A Better Start

b)     Being the Best

A letter issued by the East Midland Ambulance Service NHS Trust on the progress with the Being The Best Review was noted.

The meeting closed at 8.20 pm