The Chair together with the Divisional Director Public Health to give a short introduction to the work of the Commission. A short video (approximately 6 minutes) produced by the Kings Fund will also be shown as a useful guide to the structure of the NHS in England.
Minutes:
The Chair, together with the Divisional Director, Public Health, gave a short introduction to the work of the Commission. A short video produced by the Kings Fund was shown as a useful guide to the structure of the NHS in England. A brief guide to health structures from 2013 was also circulated to members at the meeting.
The Chair commented that health scrutiny involved a complex and widespread subject area which had grown further by the Council taking on the public health function in April 2013. It was not possible to scrutinise all issues of concern in any single year and the Commission, therefore, needed to focus on specific areas over a two/three year cycle. He felt that the future work areas could include budgetary priorities and focus on the work of the Council either through scrutinising the work of the public health team or the work of the Health and Wellbeing Board with a view to adding value to what was already being done by the Council.
The Divisional Director, Public Health, circulated a short discussion paper which identified number of factors that could be discussed when considering priorities for the Commission’s forward plan. These included:-
· The major health and wellbeing issues faced by the City included in major strategy and policy documents.
· An understanding of the population demographics and their health needs identified in the Director of Public Health’s Annual Report or Joint Strategic Needs Assessment.
· Specific issues raised by public/patient organisations and HealthWatch etc.
· Stakeholders concerns such as those raised through the recent engagement events with the voluntary and community sector.
· Awareness of other inspections and governance work carried out by the Care Quality Commission, Monitor and Chief Inspector of Care, particularly to avoid duplication.
Other factors which could influence the Commission’s priorities could be the Strategic Priorities in Closing the Gap – Leicester’s Health and Wellbeing Strategy 2013-2016 and the main causes of premature deaths in Leicester such as cardiovascular disease, diabetes, cancer, respiratory disease and infant mortality. Other significant areas of health which have been identified as having a relevant impact upon the health of residents could also be considered such as:-
· the promotion of mental health and treatment and support for those with mental illnesses.
· Sexual health and HIV.
· Oral health.
· Health protection - immunisation, screening and health protection.
During discussion the following comments were made which should also be considered:-
· Patients and users needed to be included in the planning of services and not just the quality of service delivery.
· Work needed to be undertaken with the Health Trusts to allow sufficient time for the Commission to consider and make comments on Quality Accounts in advance of the statutory deadlines, rather than the current practice where the Commission has to consider them after the deadline.
· Although the performance in the Accident and Emergency had improved to over 90% of patients being treated within the 4 hour target period; there was an emerging picture that there was a high proportion of elderly people waiting longer during the 4 hour period.
· The research work undertaken by Leicester University could be of interest to the Commission. The Deputy City Mayor commented that the public health team were already engaged with research projects at both Leicester University and De Montfort University and some of this work had been considered in relation to the work of the Health and Wellbeing Board.
· HealthWatch commented that many reports they considered did not have equality impact assessments to demonstrate that services and proposals for change had taken these considerations into account. Commissioners should be aware that HealthWatch needed this information in order to inform their work and priorities.
The Chair commented that a number of the issues above could be best dealt with by including them in scoping documents and commissioning requirements for services. He also felt that the scrutiny function could also be undertaken by Task Groups of 2 to 3 members to look at specific issues and report back to the Commission.