Agenda and minutes

Apologies for absence were received from Councillors Chaplin, Corrall and Sangster. Councillor Waddington also submitted her apologies due to her attendance at her Ward Community Meeting. 

Councillor Cleaver, currently Vice Chair of the Adult Social Care Scrutiny Commission and who had previously been a member of the Health and Wellbeing (H & WB) Scrutiny Commission was present as substitute for Councillor Sangster.

Councillor Cassidy who had previously been a member of the H & WB Scrutiny Commission was present as a substitute for Councillor Waddington.

Councillor Dr Moore, Chair of the Children, Young People and Schools (CYPS) Scrutiny Commission was present as a substitute for Councillor Corrall. Councillor Dr Moore had previously chaired a joint CYPS and H & WB Scrutiny Commission, where the Children and Adolescents Mental Health Service had been considered.

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

No declarations of interest were made.

The minutes of the meeting held on 11 January 2018 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/ieListMeetings.aspx?CId=737&Year=0

RESOLVED:

that the minutes of the meeting of the Health and Wellbeing Scrutiny Commission held on 11 January 2018 be approved as a correct record.

The Chair welcomed the list of acronyms that had been included in the agenda and asked for the list to be regularly updated and included in future agendas.

To receive updates on the matters considered at previous meetings of the Commission.

The Chair provided an update on the following items that had been considered at a previous meeting:-

·      The planning application for the Sexual Health Clinic in the Haymarket Shopping Centre had been approved at a meeting of the Planning and Development Control Committee.  There was a need for Members to look at some of the broader issues relating to the clinic and the Chair welcomed ideas from Members as to what they would like to scrutinise. The Chair added that it was good that funding was being put into the service.

·      A response to a question relating to Turning Point, had been received from the Director of Public Health and is set out below:

At the last Health Scrutiny meeting we had a discussion about Turning Point and Cllr Chaplin raised a concern that adults who turned up at Granby Street (which is the location of the children and young people’s service) rather than Eldon St where the adult services are based, might miss out on treatment. We have picked this up direct with Turning Point and they’ve given some further information about how they manage this.

They have a duty system at Granby Street. A member of staff, each morning and afternoon, has responsibility for anyone who turns up at Granby St as well as taking any phone calls to the service. If anyone comes to Granby Street by mistake, they are redirected to the right service. Where possible, a worker will walk them to Eldon Street.

Turning Point have a number of adult service users who turn up at Granby Street asking for information about their appointments. Staff will check the system and let them know the time and venue of their appointment. They will also let the service user’s own recovery worker know if there are any issues (for example, that they will be late as they presented at wrong address).

I hope this helps but if you do hear of any instances where this has not happened, please do let us know.

·      The Public Health Performance Report would be brought back to the Commission in the new municipal year, possibly in the form of a briefing. The meeting was inquorate when it was discussed in January 2018.

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 the following questions had been submitted from Ms Sally Ruane:

·       Can the STP leads give any clarity regarding precisely (rather than impressionistically) how an Accountable Care System (ACS) in LLR would differ from current arrangements?

·       What legal basis is there for an ACS?

·       What planning period is being used as the basis for STP proposals and is this adequate?

·       What is the estimated deficit in current acute bed numbers revealed by the winter crisis, black alerts, critical incidents etc and how does this affect the STP?

·       Within the 2016 draft STP, there was a requirement to make savings to the tune of £29m (rumoured to be higher in the 2018 STP) from the Continuing Healthcare Budget. With City & WL CCGs agreeing a very different Settings of Care Policy from ELR CCG, how will the STP deal with the inequalities that will arise across LLR?

·       How can the proposed formal public consultation on acute and maternity reconfiguration be genuine when ITU at the General is planned for closure?

·       Why does the revised STP continue to be withheld from the public? When will it be made available and when will the formal public consultation begin?

The Chair stated that questions had been forward to the Managing Director, West Leicestershire Clinical Commissioning Group for a response.

Questions had also been submitted from Councillor Chaplin and had been forwarded for a response.

The Chief Executive of the Leicestershire Partnership Trust submits a report that advises of the outcomes following the Care Quality Commission’s (CQC) inspection of the Leicestershire Partnership NHS Trust (LPT) undertaken 9 October - 21 November 2017. The Commission is invited to note and comment as it sees fit.

The Chief Executive of the Leicestershire Partnership NHS Trust (LPT) submitted a report that advised of the outcomes following the Care Quality Commission’s (CQC) inspection of the LPT which was undertaken 9 October -- 21 November 2017.

Dr Peter Miller, the Chief Executive and Ms Liz Rowbotham, Non-Executive Director and Chair of the LPT Quality Assurance Committee were in attendance to present the report and respond to comments and queries from Members.  Dr Miller explained that as part of its new regime, the CQC carried out inspections every year and chose five services to inspect, based on a risk based approach. For example, services that were judged to be inadequate would be inspected every year; services that were judged to require improvement, would be inspected every two years.

The Chair referred to the inspection report and expressed concerns at the number of recurring themes that were being highlighted by the CQC as areas for improvement.

Dr Miller explained that the CQC had found some improvement in each of the services they had inspected. The Children and Adolescents Mental Health Service (CAMHS) had been rated as inadequate at the previous inspection but had improved since then. However, it was recognised that the service needed to improve further. The core child mental health services were in demand and currently there were about 1000 children waiting to be seen; but there were being monitored in a regular way which was why the service was judged to be improving. A Member expressed concerns that with as many as 1000 children waiting to be seen, it was unlikely that CAMHS would receive a good rating at the next inspection.  Members heard that other improvements also included progress in addressing ligature points.

Dr Miller also referred to the areas that the CQC had highlighted as requiring improvements. These included issues with staffing levels and high case-loads in community teams, significant levels of agency staff and issues around clinical supervision as the LPT was not meeting its own targets. The CQC had also highlighted for improvement the two and four bedroom dormitories in mental health wards, but significant investment was required to change those environments.  Members heard that there would be a new children’s mental health unit on the Glenfield Site which would prevent children going out of the area for treatment.

In response to the CQC findings, a new Action Plan had been drawn up; Members received an update on this from Ms Rowbotham. Members heard that a local leader was responsible for managing the actions within the plan and committees had been assigned to each action. Any actions from the previous plan which had not been signed off had been incorporated into the new Action Plan.  In response to a query, Members heard that the format of the plan looked very similar to the previous plan and would mainly focus on the ‘must do’ items. The ‘should do’ items were being tracked by the relevant director and would not be forgotten.

A Member  ...  view the full minutes text for item 72.

The Director of Urgent Care Performance, West Leicestershire Clinical Commissioning Group, submits a report that provides an update on winter pressures, the response of the local health and care system to winter pressures and the effectiveness of winter plans.  The Commission is asked to note and comment as it sees fit.

The Scrutiny Commission received an update from the West Leicestershire Clinical Commission Group (WLCCG) on the Winter Plan 2017/18. Tamsin Hooton; Director of Urgent and Emergency Care, WLCCG and Eileen Doyle, Chief Operating Officer, University Hospitals Leicester (UHL) were in attendance to present the report.

The Chair expressed concerns about reports of the norovirus, surgery cancellations and ambulance waiting times point which indicated that the NHS was not working effectively, albeit that it was recognised that staff were working extremely hard under considerable pressures.

Ms Hooton explained that the WLCCG had been given £4.2m for winter care; some of which had been used to increase capacity.  The Christmas and New Year period had been the most challenging that they had experienced. Discharging patients from hospital at Christmas time was problematical because care workers wanted to take time off to be with their families. The hospitals had been nearly full at Christmas, though that was not due to a lack of effort or blockages in the discharge process.  There had been an approximate 12 hour wait at New Year; a very unusual situation which impacted on ambulance hand over time.  Ms Hooton explained that over the last 12 months, waiting times had been generally good and it was rare to exceed a two hour wait.

Ms Doyle updated the Commission on issues around cancelled operations. Members heard that she had been the Chief Operating Officer at the UHL since 2 January 2018.  Ms Doyle said that it was fairly unprecedented that so many operations for cancer patients had to be cancelled. This was due to the fact that most of the patients required big operations and would have needed to be admitted into the Intensive Care Unit ITU) afterwards, but the ITU beds had been fully occupied by patients, some of whom had been critically ill with flu. The patients whose operations had been cancelled had been re-booked as quickly as possible; this was not something that UHL would ever want to do, but carrying out the operation and not taking the patient to ITU would have put them at a bigger risk than not having the operation.

In response to a question, Ms Doyle said that there was a duty to report on cancelled urgent operations. If there was any risk that the patient would have a cancelled operation, the aim was to talk to the patient at least the evening before. Staff stayed in touch, the situation was tracked and monitored very closely.  The Commission heard that the situation was improving but it was a slow process and other operations had to be postponed.

In response to a question as to what was being done to prevent a similar occurrence next year, Members heard that planning had already started and efforts were being made to recruit as many nurses as possible. There were however 550 nursing vacancies in the UHL. In relation to the numbers of people with flu, Members heard that although there had not been a flu  ...  view the full minutes text for item 73.

The Commission will receive a verbal update on the Sustainability and Transformation Plan.

The Chair asked Members to note that the Commission would be looking at the Integrated Care System (that used to be called the Accountable Care Organisations) as part of the future work on the Sustainability Transformation Plan.

The Commission will receive a verbal update on the Lifestyle Services Review.

The Chair reported that a briefing for Members of the Commission on the Lifestyle Services Review had been arranged for 21 March 2018. The Consultant in Public Health said that it was hoped that the consultation would commence in April, after the Members briefing.

The Scrutiny Policy Officer submits a document that outlines the Health and Wellbeing Scrutiny Commission’s Work Programme for 2017/18.  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 2017/18.  Members of the Commission were asked to note the Work Programme.

The meeting closed at 7.59 pm.