Agenda and minutes

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 minutes of the meeting held on 14 January 2016 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=7013&Ver=4

AGREED:

That the minutes of the meeting held on 14 January 2016 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 Chair indicated that she had received the following questions submitted at late notice and would take them at the meeting:-

QUEENS ROAD MEDICAL CENTRE

Mr David Shelley asked the following questions and responses had been submitted by the Leicester City Clinical Commissioning Group prior to the meeting:-

1)         There is public concern that the meeting on 14th January which decided the future of the Queens Road Medical Centre was held in private. Consequently it is difficult for the decision making process to stand up to scrutiny, and public confidence in the CCG has been damaged.  Why was it necessary for this meeting to be held in private, particularly given that the CCG has said that they had no access to the financial records of the practice when making the decision?

Response from the CCG

This question was answered in the meeting with Jon Ashworth MP on 26th February. It was necessary for this item to be taken in confidential session as the papers considered by the committee contained information that was commercially confidential and information personal to individuals employed by the practice. Although the CCG did not have access to the full accounts of the practice the papers presented disclosed information relating to the full NHS income of Queens Road Medical Centre, from which it may have been possible to deduce the profit of the practice. It also contained information about the personal details of employees of the surgery. This included their annual salaries, length of service and redundancy liabilities. This information was vital in making an assessment as to the likely ongoing viability of the practice. It would not have been appropriate to make this information available publicly and to do so is likely to have been unlawful as it may well have represented a breach of data protection legislation.

The CCG tries to undertake as much business as is possible in its public meetings. However, from time-to-time this is not possible. Where an item is deemed necessary to be considered in confidential session the reasons for this must be clearly explained to the relevant committee.

2)         Campaigners reported there were parties who have expressed an interest in taking over the running of the practice, who believe that the practice would be financially viable, and who have said they would be able to deliver continuity of care for patients in the available time.  Why did the CCG believe that this would not be the case when taking the decision to disperse the patient list?

Response from the CCG

This question has been answered at the public meeting on 25th February and the meeting with Jon Ashworth MP on 26th February. The CCG could not have sought to establish a partnership arrangement on behalf of Dr Lenten or the practice. Contractual partnerships between GPs are private matters between the individuals concerned and it would be wholly inappropriate for  ...  view the full minutes text for item 68.

The Chair to update Members on the work of the Task Group and to receive any evidence that has been submitted prior to the meeting.  An extract of the Minute of the Health and Wellbeing Board held on 2 February 2016 relating to the issue is attached for information.  

The Chair updated Members on the work of the Task Group and the Commission received evidence that had been submitted prior to the meeting. An extract of the Minute of the Health and Wellbeing Board held on 2 February 2016 relating to the issue was previously circulated for information with the agenda.

The evidence received at the meeting included a formal response from the Deputy City Mayor to the Task Group’s Review, the views of Professor Harris at the University of Leicester and a briefing paper form the National Health Executive.

Prior to discussion on the Task Group’s work,the Director of Corporate Affairs, Leicester City Clinical Commissioning Group reported that Danum Medical Services had advised the CCG that they would not be able to fulfil their contractual obligations to provide GP services at Asquith Surgery and Bowling Green Surgery after 11 March 2016.

The CCG had put in place temporary and urgent measures to allow patients to receive care at both practices as normal through caretaker arrangements from other local providers until a longer term solution could be found.  Both practices would still be able to register new patients.  This had only been possible in this instance as both premises were owned by the NHS and had list sizes that were likely to make practices clinically and financially viable going forward.

Expressions of interest were being sought from other GP practices wishing to take on this role and any bids received would be evaluated and it was hoped to make an announcement on March 14^th.

Following comments from members, the Director of Corporate Affairs, Leicester City Clinical Commissioning Group stated that single handed GP

Practices were more vulnerable than larger practices, particularly when the principal GP wished to retire or resign.  Practices affected by the changes from PMS to GMS contracts were also potentially vulnerable, and CCG staff had been in discussions with those practices affected to determine the effects this may have.   The CCG were seeking assurances from GPs moving from PMS to GMS contracts that they had plans in place to enable the practice to manage in the future.  To date some practices were developing plans and others required additional support in the process.

Those GP practices that could not demonstrate they could provide the additional services required by the new national contracts would have their funding reduced over a 6 year period. 

The Chair referred to the suggestion at the Health and Wellbeing Board that single GP practices be invited to enter into a voluntary agreement to give 6 months’ notice rather than the 3 months required by the national contract agreement.  The Director of Corporate Affairs, Leicester City Clinical Commissioning Group stated that some had already agreed to this and others were still in discussion.

It was noted that 4 GP service hubs established by the CCG earlier in the year had provided approximately 2,000 extra patient appointments per week.  The hubs were well used Monday to Friday but there was a drop  ...  view the full minutes text for item 69.

The Deputy City Mayor to outline the current work of the Health and Wellbeing Board.

The Deputy City Mayor outlined the current work of the Health and Wellbeing Board and stated that at the Board meeting in February it had:-

a)         Approved the 2016/17 Better Care Fund Plan.

b)         Approved the Mental Health Joint Commissioning Strategy.

c)         Considered the 2016/17 - 2020/21 NHS Planning Guidance

d)         Received a presentation and discussed the UHL strategic priorities.

e)         Discussed the Primary Care Workforce Planning and the Board had suggested seeking a voluntary agreement to GPs giving a six month notice period rather than the 3 months in the national contract.

He had attended the public meeting organised by the CCG in relation to the Queens Road Medical Centre and had met with campaigners and was involved in ongoing discussions with the CCG and others.

He was also arranging a Primary Care Summit to discuss a Primary Care vision and strategy.

f)          Other areas of the Board’s current work included:-

Joint Health and Wellbeing Strategy 2016-19

Sustainability & Transformation Plan LLR

Community Pharmacy

Public Health grant

Health Education East Midlands workforce plan

Better Care Together

Strengthening links between Learning Disability Partnership Board, Mental Health Partnership Board & Health & Wellbeing Board

 g)        As Chair of the Board he was also involved in following activities:-

#timetotalk day & employers pledge

Health in all Policies workshops

Mental Health Summit

East Midlands Health & Wellbeing Boards Chairs network

LGA Health & Wellbeing Boards chairs summit

Following questions from Members, the Deputy City Mayor stated that there was now a wealth of data that had been accumulated from a number of health surveys over recent years and this was informing and shaping the development of the Joint Health and Wellbeing Strategy 2016-19.   He wished to develop a strategy that clearly set out a long term ambition beyond the 3 year life of the strategy.

In relation to Sustainability & Transformation Plan LLR (STP), it was intended to align this as close to the Better Care Together Programme (BCTP) as possible to avoid unnecessary duplication, whilst recognising that the STP had a wider remit that the BCTP.

The Chair thanked the Deputy City Mayor for his update.

To receive an update report on the Anchor Centre.

The Commission received an update report on the Anchor Centre.  The Assistant City Mayor Public Health stated that:-

a)         The Council had been successful with its capital bid in partnership with Inclusion Healthcare to Public Health England and had been awarded £267,861 to develop suitable accommodation for the service and to support people using the service towards recovery.

b)         The proposed model for the Anchor Recovery Hub was outlined in the report and a project team had now be established to develop plans for the new service and to complete an options appraisal for possible sites for the recovery hub in an suitable and appropriate location.

c)         A waiver had also been obtained to extend the current contract with Inclusion Health for one year to allow the time to get the new service model in place before the service was re-commissioned.

Following discussion and comments it was noted that:-

a)          the Council had received positive feedback from Public Health England on the quality of the bid application.

b)          the costings for the grant application had been based upon renovation costs and the number of clients that would use the service.

c)          the centre would now be called the Anchor Recovery Hub to reflect its new role to stabilise service users’ alcohol use, engage and maintain contact with treatment services and mutual aid to improve their physical and mental health and to help users learn new skills.

d)          that service users and the service providers were involved in preparing the joint bid.

The Chair welcomed the developments and felt this was a good example of scrutiny helping the Executive to look at the facility in a different way.  Further updates on the Recovery Hub were requested.

AGREED:

That the update report be welcomed and that further reported be submitted to future meetings.

To receive a report from Healthwatch Leicester providing an overview of a number of visits to the Urgent Care Centre at Leicester Royal Infirmary that were carried out in November 2015.   A copy of Healthwatch Leicester’s Report “Using Urgent Care Services in Leicester City” is also attached.

Healthwatch Leicester submitted a report providing an overview of a number of visits to the Urgent Care Centre at Leicester Royal Infirmary that were carried out in November 2015.

AGREED:

                        That that report be received and noted.

To receive an update on the NHS 111 service previously considered at the Commission’s meeting on 29 October 2015.  (Minute 41 refers)  

The Commission received an update on the NHS 111 service previously considered at the Commission’s meeting on 29 October 2015. (Minute 41 refers).

The Director of Corporate Affairs, Leicester City Clinical Commissioning Group reported that the report on the investigation carried out by North Derbyshire CCG originally expected to be available in January had been delayed.  It was expected that the report would be available for the Commission’s next meeting on 21 April 2016.

AGREED:-

That the report on the outcomes of the investigation carried out by North Derbyshire CCG be submitted to the next meeting of the Commission.

To receive a presentation from the Leicester City Clinical Commissioning Group on the recent issues relating to the service.

The Director of Corporate Affairs, Leicester City Clinical Commissioning Group provided an update on the recent issues relating to the Arriva Patient Transfer Service.

It was noted that:-

a)         The contract was awarded to Arriva in 2012 for a 5 year period with a value of £26m.  There was a provision in the contract for it to be extended.

b)         Prior to 2012, the contract had been awarded to EMAS and there had been a number of performance issues during the contract.

c)         There had been a number of performance related issues during the current contract with Arriva, some of which arose from Arriva’s operations and some from health service procedures.

d)         Current issues experienced were unacceptable waiting times for pre-planned appointments, patients being discharged from hospital waiting more than 2 hours, and difficulties in servicing rural areas where patients had experienced too many delays in being taken to their appointments or transport failing to turn up altogether.

e)         Discussions had been held with Arriva who were being responsive to the issues being faced and some improvements in performance had been observed during the previous three months.

f)          The procedures for discharging a patient in the Urgent Care Planning process often meant that Arriva were not notified until the end of the process and that could cause planning issues for staff planning for Arriva.  Equally there were instances where Arriva had arrived to pick up a patient and the patient had not been fully discharged.  This problem was not just local but was part of a wider issue.

g)         It was recognised that the health and care system was different now to when the contract was awarded in 2012, as there was more demand being placed upon Arriva than in 2012.

h)        Commissioners of the service were now looking at the contract details and whether to extend it beyond 2017.  Commissioners were conscious that the contract should be fit for purpose, it should meet the needs of the patients and that patients should be involved in shaping the future of the service.

The Chair thanked the Director of Chief Corporate Affairs, Leicester City Clinical Commissioning Group for the update.

AGREED:

That the update report be received and further update be presented to the next meeting of the Commission.         

To receive an update on the work of the Task Group in relation to this scrutiny review.

The Commission received an update on the work of the Task Group in relation to this scrutiny review.  The Chair stated that although some progress had been made with the review the review had not been completed as, available resources had been prioritised to complete the Primary Care Workforce Review. 

Councillor Alfonso had arranged with the Head of Markets for a health messaging event to be held at the Leicester Outdoor Market.  Councillor Alfonso outlined the programme for the event which would be attended by the City Mayor, Lord Mayor and ex Lord Mayors on 1 April 2016 at 11.30am.  Members were encouraged to attend the event.

The Chair thanked Councillor Alfonso for helping to organise the event.

AGREED: 

                        That the update report be received.

To receive an update on the work of the Task Group in relation to this scrutiny review.

Councillor Sangster provided an update on the work of the Task Group on ‘Leicestershire Partnership NHS Trust – Quality monitoring following the Care Quality Commission Inspection’.  It was hoped that the Review Report would be available in April.

The Chair encouraged Members to attend Task Group meetings. 

AGREED:

That the report be received.

The Scrutiny Policy 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 2014/15.

The Chair referred to the current consultation taking place on the Disability Related Expenditure under the Care Act 2014 and asked for this to be added to the Work Programme. The Strategic Director of Adult Social Care briefly outlined the arrangements for the consultation and the proposed changes.  This item was not currently on the Adult Social Care Scrutiny Commission’s Work Programme; but the Director undertook to discuss this with the Chair of the Adult Social Care Scrutiny Commission.  If it was decided to add it to their Work Programme a copy of the report would be copied to the Commission for information.

AGREED:

That the Work Programme be noted and that the following items be added:-

a)         Future Budget Items – April Meeting

b)         Maternity Care Services

The meeting closed at 8.05 pm.