Minutes for Overview and Scrutiny Committee (Health and Social Care) meeting, Mar 3 2009, 6.30PM official page

Apologies for absence were received from Councillors P Hardy, T Jones and Bigley (Substitute for T Jones); Ann Bisbrown-Lee, Sefton LINk; John Rimmer, Rick Halsall and Len Gibbs, ARRIVA; All Executives, Mersey Care NHS Trust.

(Including Party Whip Declarations)

Members and Officers are requested to give notice of any personal or prejudicial interest and the nature of that interest, relating to any item on the agenda in accordance with the relevant Code of Conduct.

The following declaration of interest was received:-

Member

Item

Reason

Action

Councillor Hill

65. Southport & Ormskirk Hospital NHS Trust

Personal – his Wife is employed by Southport & Ormskirk Hospital NHS Trust

None taken

Minutes of the meeting held on 27 January 2009.

RESOLVED:

That the Minutes of the meeting held on 27 January 2009 be confirmed as a correct record.

Verbal updates on action plans put forward in October 2008 from ARRIVA, Mersey Travel, NHS Sefton, Southport and Ormskirk Hospital NHS Trust and Sefton Council.

The Committee considered the progress on action points put forward by Southport and Ormskirk Hospital NHS Trust, NHS Sefton, Sefton Council, ARRIVA and Mersey Travel in October 2008 in response to improving public transport to Southport and Ormskirk Hospitals:

Technical Services, Sefton MBC:

(A)   Look at the opportunities for addressing these issues through the use of community transport – The Community Transport Group were looking into the funding to carry out this action;

(B)   Explore the use of the Park and Ride service to improve access to the hospitals – On 4 January 2009 a service was routed along Scarisbrick New Road to the college;

(C)   Continue to support Southport and Ormskirk Hospital NHS Trust with their Green Transport Plan – The Travelwise Transport Team would now deliver on this; and

(D)   Improve the cycle links – A range of consultations had been planned for 2009 to address this action.

Mersey Travel:

(A)  Continue to support the Green Transport Plan;

(B)  Carry forward the soft issues involved in the Green Transport Plan;

(C) Continue to stress the importance of using alternative means of transport to staff; and

(D)Determine whether there are any subsidised services and discuss this with West Lancashire.

They have had no complaints from passengers regarding the public transport services to the hospitals, although they understand the hospital remained concerned about this. Their budget was tight and they had not asked for the level of subsidiary from West Lancashire, as the services depended on public demand.

NHS Sefton agreed to:

(A)  Look at the legal position of NHS Sefton funding towards the improvement of these transport issues; and

(B)  Look into Central Lancashire’s community transport.

NHS Sefton was able to contribute funding towards these actions, but asked whether it would be more cost effective to use the Council’s Community Transport. They continued to work closely with Travel Wise on the Green Travel Plan.

Southport and Ormskirk Hospital NHS Trust agreed to:

(A)  Work with travel partners in addressing these issues.

The revised Park and Ride route went live on 1 January 2009 and the hospital trust continued to be active in the Green Transport Plan. Their Communications Officer had been off ill for the last few weeks, but would distribute information relating to this when she returned to work.

ARRIVA agreed to:

(A)  Maintain their involvement in the Green Transport Plan Group;

(B)  Continue to monitor and improve services;

(C)Work together with travel partners to improve services.

They had fulfilled all their obligations and actively involved in improving services during the last few months. They were obliged to attend two meetings per year and ensured the Committee that their communication was back on track. The bus routes were timetabled to go to both hospitals. However a commercial decision was made to reduce the frequency of services from every 15 minutes to every 30 minutes, which coincided with another service being withdrawn from another supplier. Due to these changes, there were now 2 buses per hour instead of the previous 6 buses per hour. To compensate for this shortfall, double-decker buses were used to alleviate the capacity problems. ARRIVA also discussed the potential to go into partnership with other large organisations to improve the frequency of services.

Further discussions took place from Members questions:

• Up-to-date survey to capture the public’s opinion on transport links to Southport and Ormskirk Hospitals.
• Public transport links to the hospitals for people traveling from the Formby area.
• The use of double-decker buses and their accessibility to people with disabilities.
• Signage to the hospitals, especially children’s A&E at Ormskirk.

RESOLVED That:-

(1)   each organisation that updated the Committee be thanked for their contribution and progress made against action points;

(2)   the updates on action points be noted;

(3)   the Community Transport still needs to be improved and partner organisations will need to work together to address this;

(4)   Technical Services and the hospital trust will determine a solution to improve the signage to the hospitals;

(5)   each organisation will report to this Committee on their progress in 6 months time with concrete proposals

(6)   NHS Sefton to review the issue of access and transport

Report of the Chief Executive

The Committee considered the report of the Chief Executive, NHS Sefton (the Trust) detailing current issues impacting on healthcare provision in Sefton, which included a verbal update by Dr Janet Atherton, Director of Public Services and Paul Acres, the Chairman on the following issues:

(A)  World Class Commissioning

The trust had received their first assurance report for world class commissioning, a national programme designed to deliver benefits to local people based on best practice from around the world.

The trust was assessed by a panel of experts in November 2008, which formed the basis for their performance report. Three key areas were looked at: progress on addressing local health priorities, commissioning capabilities and the effectiveness of management arrangements. The report highlighted strengths in the trust’s plans to develop future services and the need to progress in areas such as developing services for Sefton’s ageing population and those with long-term conditions.

This report would help the trust make significant improvements to health and wellbeing, and reduce health inequalities.

The trust’s draft strategic plan ‘Better Health, Better Life’ was one of the documents reviewed by the panel and the final version of the trust’s plan would take account of the panel’s comments.

(B)  Better Health, Better Life

More than 70,000 people had given their views as part of the consultation on the trust’s draft strategic plan ‘Better Health, Better Life’, which was now in the collation and analysis stage along with integrating feedback from the world class commissioning report.

A final version of the trust’s strategic plan would be presented to the NHS Sefton Board in March 2009.

Further discussions took place from Members questions:

• Benefits of surveys versus costs;
• Concerns regarding dementia and long-term conditions;
• Effective consultations and development.

(C)New sexual health service launched

Improving Sexual Health in Sefton (ISIS), the new sexual health service in Sefton was launched in January 2009. ISIS offers services for all ages and the number of clinics and contact points would increase, so more people can get help, advice and treatment along with later opening times.

ISIS included a range of services and was run by NHS Sefton Provider Services, which had managed the local Chlamydia screening programme since October 2008. The first 10 weeks of operation ensured 100 more young people had been tested and these figures were expected to increase even further in the future.

Further discussions took place from Members questions:

• The recommendations that had been addressed by the trust from the Overview and Scrutiny Report on Sexual Health;
• The number of outlets in Sefton and plans for development;
• Sexual Health Services and access to schools;
• Alcohol related pregnancies and sexually transmitted diseases;
• Comparisons to Scotland and their initiatives investigating risky behaviour.

(D) Landmark constitution for NHS

The NHS in England published a Constitution in January 2009, which set out what people could expect from the NHS. It empowers people and highlights their existing rights, so people know what they are entitled to and how they could exercise their rights as well as understanding their responsibilities.

Lord Darzi’s review of the NHS ‘High Quality Care for All’ concluded that there was a case for a NHS constitution to enshrine the principles and values of the NHS in England.

Everyone was invited to give views about the constitution, which helped shape this landmark document. The resulting constitution was designed to safeguard the future of the NHS and renew its core values, ensuring that it continued to be relevant to the needs of patients.

(E)  Update on plans for a children’s walk-in centre

The trust had been finalising their plans for their proposals for a children’s walk-in treatment for north Sefton. They shared their options for a minor injuries and ailments unit with a number of interested partners at the end of 2008, and asked for their views on moving the project forward.

The trust stated that they would keep the Committee updated on their progress and remain hopeful that the centre would be open by the end of 2009.

Further discussion took place from Members questions:

• Blood tests performed at the Litherland Walk-in Centre;
• GP appointment and access systems.

Dr Atherton suggested that individual incidents would be considered and responded to by the trust.

RESOLVED: That

(1)   NHS Sefton be thanked for the report;

(2)   The report be noted; and

(3)   NHS Sefton’s actions against recommendations and proposals contained in the report, be monitored as appropriate.

Report of the Chief Executive

The Committee considered the report of the Chief Executive, Southport and Ormskirk Hospital NHS Trust (the hospital trust) detailing current issues impacting on healthcare provision in Sefton, which included a verbal update by Mike Frayne, Deputy Chief Executive/Director of Performance and Steve Taylor, the Director of Transport on the following issues:

(A)  Urgent Care

During 2008/09 to date, the hospital had experienced a 2-3% increase in A&E admissions at Southport hospital and 21% increase in the number of admissions, which had resulted in pressures on bed occupancy and A&E services.

The national target to achieve 98% of patients discharged within 4 hours has not been met, and was currently running at a rate of approximately 97.3%.

The hospital trust was achieving the 18-week referral to treatment standard and had retained its excellent performance in infection control.

The hospital trust was working collaboratively with NHS Sefton to manage urgent care pressures. In addition to increased resources to support urgent care, such as additional A&E Consultants, the NHS Sefton was supporting the trust to discharge patients and respond to the findings of a review of urgent care, sponsored by the Strategic Health Authority (SHA).

Further discussions took places from Members questions:

·        Admission avoidance and interventions;

·        Effectiveness of Referrals from GPs and reviews being undertaken;

·        Turnaround and process for ambulances arriving at A&E with patients;

·        The distinction between A&E and Urgent Care.

(B)  Foundation Trust Application Process

In December 2008, the hospital trust agreed a time frame with the SHA to submit its application for Foundation Trust (FT) status, which followed a review of their readiness to become a FT trust and formally accepted the hospital trust as an aspirant FT.

One of the main benefits to the hospital trust and the local community of becoming a FT was the change in governance arrangements, which included a Council of Governors elected by members of the hospital trust and the public.

The hospital trust would be consulting on its proposals for the governance arrangements sometime in March 2009 and would last for 12-weeks. FT status would also enable the hospital trust to create a financial surplus that could be reinvested back into services for the benefit of patients.

The process would take approximately 12 months and the hospital trust would receive authorisation in February 2010 if it was successful.

Further discussion took places from Members questions regarding the process for the election of the Council of Governors.

(C) Primary Care Access Centre

The hospital trust had formed a partnership with a number of GPs in West Lancashire and had been named as the preferred bidder by NHS Central Lancashire to manage a Primary Care Access Centre, which would be located at the Ormskirk Hospital site. The Centre would consist of Urgent Care, GP Practice, GP Out of Hours and NHS Dentistry.

This service would be in place by approximately December 2009.

(D) Quality

The hospital trust was performing well against the 18-weeks referral to treatment target with 95% of non-admitted patients and 90% of admitted patients starting treatment within an 18-week maximum period from being referred by their GP.

(E)  Pride Awards

As a way of acknowledging the special people work for or give their time freely to the hospital trust, they were holding a Pride Awards Ceremony in May 2009 at the Southport Theatre and Convention Centre. There would be a range of awards nominated by members of staff and the public, as follows:

·        Team of the Year;

·        Unsung Hero – Staff;

·        Unsung Hero – Volunteer;

·        Service Transformation/Innovation;

·        Patient’s Awards;

·        Inspirational Role Model; and

·        Pennies and Pounds.

The Chair, Councillor Hill stated commented on the Pride Awards and that it was good to see there was formal recognition for these people.

The Vice Chair, Councillor McGuire formally requested a report from the trust hospital on the provision of maternity services. The hospital trust suggested that this would be possible after their April Trust Board Meeting. Therefore, it was agreed that the report would come to this Committee in May 2009.

RESOLVED: That

(1)   Southport and Ormskirk Hospital NHS Trust be thanked for the report;

(2)   The report be noted; and

(3)   Southport and Ormskirk Hospital NHS Trust’s actions against recommendations and proposals contained in the report, be monitored as appropriate.

(4)   Southport and Ormskirk Hospital NHS Trust is to present a report to this Committee on the provision of maternity services in May 2009.

Report of the Legal Director

The Committee considered the report of the Legal Director attaching the latest Key Decision Forward Plan, which contained all the Key Decisions that the Executive anticipated to take during 1 March and 30 June 2009.  The Committee was advised of its right to pre-scrutinise any Key Decisions that fell under its remit.

Members discussed the following Key Decisions with Bob McConnell, Head of Central Services and Colin Speight, Principal both from the Health and Social Care Directorate available to answer any questions:

(A)  Charging for Transport Services;

(B)  Non Residential Care;

(C)  Charging Policy for Social Care Services;

(D)  To No Longer Provide Small Aids Free of Charge;

(E)  Independent Sector Fee for Social Care Provision

The report also provided updates on recent activities of the current

Working Groups, as follows:-

• Supported Housing Needs Working Group; and
• Analysis and evaluation of Early Mechanisms in Health and social Care Working Group.

The Committee was also updated on the visit to Alder Hey Hospital for Members of this Committee, together with the Cabinet Member – Health and Social Care on Wednesday 28 January 2009.

The Chair, Councillor Hill highlighted the difficulty in pre-scrutinising Key Decisions using the 28-day rule, when the Overview and Scrutiny Committee meeting fell on a date near the deadline for the Key Decision.

RESOLVED: That

(1)   the contents of the Forward Plan, together with the report, be noted;

(2)   progress in relation to the Committee’s Work Programme and Working Groups be recognised and supported; and

(3)   the site visit to Alder Hey Hospital be noted