Agenda and minutes

The Chair welcomed everyone to the meeting and stated that due to unforeseen circumstances the meeting would not have a quorum and any decisions made at the meeting would be confirmed when the minutes of the meeting were approved at the next meeting.

Members are asked to declare any interests they may have in the business on the agenda.

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

The Monitoring Officer to report that Councillor Bajaj has been appointed to the Commission to fill the vacancy for the Labour Group vacancy, which was reported at the last meeting.

The Monitoring Officer’s report that Councillor Bajaj has been appointed to the Commission to fill the vacancy for the Labour Group vacancy was noted. The Chair stated that he would meet with Councillor Bajaj to brief him on the work of the Commission.

The minutes of the meeting held on 1 July 2014 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=6479&Ver=4

RESOLVED:

that the minutes of the meeting held on 1 July 2014 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 and statements of case had been submitted in accordance with the Council’s procedures.

The Scrutiny Support Officer submits a document that outlines the Health and Wellbeing Scrutiny Commission’s Work Programme for 2014/15.  The 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.

It was noted that further consultation has started on CAHMS (Children and Adolescent Mental Health Services).  The Chair indicated that he would discuss this further with the Chair of Children Young People and Schools Scrutiny Commission.

The Chair referred to the Department of Health’s ‘Local Authority Health Scrutiny Guidance to support Local Authorities and their partners to deliver effective health scrutiny’ published in June 2014.  He and Councillor Chaplin agreed to form a sub-group to look at the guidance and see if there were any implications for the Commission.  They would report back to the October meeting of the Commission.

The Commission is recommended to note the items that are relevant to its work in the Corporate Plan of Key Decisions that will be taken after 1 August 2014.

The Commission noted the items that were relevant to its work in the Corporate Plan of Key Decisions that would be taken after 1 August 2014.

To receive a report on the East Midland’s Ambulance Service NHS Trust. The report outlines the achievements in relation to key national performance standards.  The report also sets out the challenges faced in 2013/14 and the actions taken, together with outlining the two risk summits in 2013/14 and the progress made with the EMAS Better Care Patient Care Quality Improvement Programme. It also outlines the findings of the Care Quality Commission inspection and the actions taken to address the areas of shortfall/non-compliance.  The report also identifies the Trust’s performance both within the context of the City and specifically compared to the East Midlands as a whole.

Sue Noyes, Chief Executive and Paul St Clair, Assistant Director Operations, East Midlands Ambulance Service NHS Trust will attend the meeting to present the report.

East Midland’s Ambulance Service NHS Trust submitted a report that outlined their achievements in relation to key national performance standards.  The report also set out the challenges faced in 2013/14 and the actions taken.  It also contained details of the two risk summits in 2013/14 and the progress made with the EMAS Better Care Patient Care Quality Improvement Programme. It also outlined the findings of the Care Quality Commission inspection and the actions taken to address the areas of shortfall/non-compliance.  The report also identified the Trust’s performance both within the context of the City and specifically compared to the East Midlands as a whole.

Sue Noyes, Chief Executive and Paul St Clair, Assistant Director Operations, East Midlands Ambulance Service NHS Trust attended the meeting to present the report and made the following comments:-

·         The service had now stabilised and had moved from Phase 1 – Stabilising to Phase 2 - Transition in the Better Patient Care Programme.  Phase 2 of the Programme started in April 2014.

·         Performance in the last quarter had been good, although July had been challenging with the increased levels of patients with respiratory conditions. 

·         A diagram showing the processes for responding to 999 calls is attached as appendix to these minutes.

·         The response performance to Red 1 (immediately life threating) and Red 2 (life threatening but less time critical) and Red 19 (a patient carrying response on the scene within 19 minutes) had exceeded the performance standards for the first quarter and also July.   Red 1 and Red 2 each had a performance standard of 75% and the actual performance in Leicester was 88.66% and 84.90% respectively.  The target for Red 19 was 95% and the performance in Leicester was 97.09%.

·         The performance for less urgent responses (Green 1 and Green 2 – 20 minutes) was slightly below the target of 85% (81.23% and 84.16% respectively). However, the Green 3 (telephone assessment within 60 minutes) and Green 4 targets (telephone assessment within 60 minutes or a vehicle response within 4 hours) exceeded the standard of 85% with local responses of 92.17% for Green 3 and 100% for Green 4.

·         Further work was being carried out with the CCGs and GPs in relation to ‘urgent calls’ where GPs and other health professionals request ambulance transfers for their patients.  Although these are classed as ‘urgent requests’ a GP could request a timed response of two hours or more to carry out the journey.  The peak time for demand for this service was usually from 11.00am to 4.00pm, which put pressure on Ambulance attendance at University Hospitals of Leicester’s (UHL) A&E Department between 12.00 noon and 2.00pm.  

·         The service aimed to have 10 ambulances and hour at the UHL and this target was only usually exceeded by a small percentage point.   

·         A number of responses involve the treatment of patients at the scene and did not require the patient to be transferred to a facility for further treatment.  The target of 40% of ‘non-conveyance of patients’ was exceeded  ...  view the full minutes text for item 22.

To receive a report on the Director of Public Health’s Annual Report 2013-14.  The Strategic Director of Adult Social Care and Health will give a presentation on the Annual Report. 

A copy of the Annual Report for 2013-14 can be found at the following link:-

http://www.cabinet.leicester.gov.uk/mgConvert2PDF.aspx?ID=64402

The Director of Public Health’s Annual Report 2013-14 was received.  The Divisional Director, Public Health gave a presentation on the Annual Report, a copy of which is attached. 

A copy of the Annual Report for 2013-14 can be found at the following link:-

http://www.cabinet.leicester.gov.uk/mgConvert2PDF.aspx?ID=64402

In presenting the report the following comments were made in addition to those listed in the presentation:-

·         Although there was a statutory requirement to produce a report, there was no guidance on what should be included in the report.  However it was customary to include an assessment of the health of population and to make recommendations about things that the health system in general could do improve the health of population.

·         One of the report’s purposes was also to inform the City Council, Health and Wellbeing Board, Clinical Commissioning Group, NHS England and Public Health England and other partners about the health of the resident population and to identify key areas where improvements could be made that would benefit the health of the population.  The plan also provided information on health needs overall which informs on planning and commissioning processes.

·         The report also sat alongside the Joint Needs Assessment which helps the Health and Wellbeing Board to produce and review its Health and Wellbeing Strategy ‘Closing the Gap’.

·         In addition, the report also helps to provide a record of the health of the population which allows a comparison to be made over a period of time and with other places, both locally and nationally.

·         The striking differences for Leicester from these comparisons were:-

o   Leicester was ranked 25^th most deprived area out of 326 local authorities in England, and deprivation was the greatest single impact upon the health of the population.

o   Deprivation also leads to lifestyle factors and material conditions that can affect the health of people, e.g people living in cold damp conditions have a greater risk of heart problems etc.

o   The population of Leicester has a very rich diversity.  There are 18 different ethnic groups in the City with populations of 1,000 or more identified in the 2011 census.  (37% Asian/Asian British, 6% Black/Black British, 46% White and 4% Other White groups from Poland and other EU succession countries.

o   Different ethnic backgrounds have different predispositions to health conditions.  Lifestyle factors deeply embedded in the lives of people from different cultures can impact upon health either to increase the risk of, or be a protective factor against, particular health conditions.

o   Leicester’s population is relatively young in nature.  34.5% of households have dependent children (29% nationally) and 20% of the population in Leicester are aged 20 – 29 years old compared to 14% nationally.

o   There are also significant socio-economic challenges in Leicester.  29% of adults have no educational qualification and 35% of 16-74 year olds were economically inactive compared to 30% nationally.

o   All these factors had a high impact upon health and health needs.

·         The top three causes of deaths in the population under 74 years old were cancer,  ...  view the full minutes text for item 23.

To receive a report from Leicester City Clinical Commissioning Group on the proposal for co-commissioning arrangements with NHS England in relation to GP services.  A copy of a hand-out from the LCCCG on the inspections by the Care Quality Commission together with a copy of a presentation on the inspections is attached for members’ information.

RESOLVED:           

That the item be deferred until the next meeting of the Commission.

The Chair to lead a discussion on the current progress of the Congenital Heart Services Review being undertaken by NHS England.

The last update report is attached and can be accessed at the following link.  The link will also allow access to previous update reports.

http://www.england.nhs.uk/category/publications/blogs/john-holden/

HealthWatch Leicester, Heartlink, University Hospitals Leicester NHS Trust, Keep The Beat, and representatives of East Midlands Health Scrutiny have been invited to contribute to the update.

The Chair led a discussion on the current progress of the Congenital Heart Services Review being undertaken by NHS England.

The last update report from NHS England had been circulated to members of the Commission prior to the meeting.  The link below will allow access to this and previous update reports.

http://www.england.nhs.uk/category/publications/blogs/john-holden/

Details of the current expected timetable for the review, together with a briefing paper issued by NHS England (1 August 2014), a report to the University Hospitals of Leicester NHS Trust Board (UHL) (31 July 2014) on the future provision of Paediatric Surgery at UHL and various comments received from interested parties on the review, together with a press article dated 5 August 2014 was circulated to everyone at the meeting.

The Chair stated that he wished to review the current progress as he was uncomfortable with the recent comments and concerns expressed by some of those involved in the review.  The Chief Executive of UHL had recently made an announcement that the Trust were considering a proposal to move some children’s services from the Glenfield Hospital site to the Royal Infirmary site so that all paediatric services were co-located on one site.  The Chair commented that this announcement had been unexpected.

The Chair also commented that some comments had been made to suggest that the principles of the Safe and Sustainable review were being re-introduced gradually as a view was emerging that there should be fewer and larger centres and the virtues of centralising services had been made in number of statements relating to trauma centre and specialist stroke care units.  It was also noted that the UHL Board had approved the recommendations in the report at its meeting on 31 July 2014.

Kate Shields, Director of Strategy, University Hospitals of Leicester NHS Trust made the following comments:-

·         The current expected timetable for the review had only been presented to everyone recently.

·         There had been a statement in the minutes of a recent meeting of the review’s Clinical Advisory Panel (CAP) that the co-location of children’s services was more important than the number of operations carried out by centres. This statement had not been expected.

·         Following recent discussions with the review team, there appeared to be more latitude in relation to compiling the number of operations performed by each centre.

·         There had been useful discussions with Birmingham’s Queen Elizabeth Hospital in relation to the review.

·         There appeared to be more co-operation and trust between Clinicians reflecting the open and transparent manner in which the review was being conducted.

·         Clinicians at UHL had been considering the co-location of paediatric services on one site for some time, but the statement in the CAP minutes had made the Trust look at the issue more quickly.  It was proposed to take a further report on the feasibility of the proposal to the September Trust Board meeting.

·         Centres such as Blackpool, Papworth and Brighton seemed to fit well with the proposed standards on their own but not in relation to transition services.  ...  view the full minutes text for item 25.

The Chair will provide feedback on discussions with the Healthwatch representative on how the Commission should consider the Quality Accounts in the future as agreed at the last meeting of the Commission.

The Chair provided feedback on discussions with the Healthwatch representative on how the Commission should consider the Quality Accounts in the future, as agreed at the last meeting of the Commission.  A draft paper outlining the process was circulated to everyone present at the meeting.

RESOLVED:

1)         That the process outlined in paragraphs 4.1 to 4.9 be adopted for the future consideration of Quality Accounts and that the relevant providers of healthcare services in the City, who are required to submit Quality Accounts, be advised of the Commission’s process.

2)         That a meeting of the Commission be arranged in early June in future years to enable the Commission to consider Quality Accounts and submit comments to the providers in order to allow them to submit the final Quality Accounts to the NHS Choices’ website by 30 June each year.

a)     Public Health England - Leicester Health Profile 2014

Public Health England published the Health Profile 2014 for Leicester on 8 July 2014.  

The following items and information were noted by the Commission:-

a)     Public Health England - Leicester Health Profile 2014

Public Health England published the Health Profile 2014 for Leicester on 8 July 2014. 

b)   Review of Mental Health Services for Young Black Men

Two further meetings had been arranged for the review as it was evident, after the first two meetings to gather evidence, that evidence from further interested parties was required.  The meetings had been arranged for 10 and 30 September 2014 at 5.30pm.

The Chair agreed to note the following item which had been made public since the agenda had been published.

c)    Summary Hospital Level Mortality Indicator – (SHIM) UHL NHS Trust

Summary Paper on Learning Lessons to Improve Care – a joint review of quality of care delivered to patients who died in Leicester, Leicestershire and Rutland 2012-13.

The Chair indicated that this may be considered at a future meeting of the Commission.

The meeting closed at 7.50 pm.