Agenda and minutes
PDF 63 KBVenue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN
Contact: Ross Pike or Andrew Baird Email: ross.pike@surreycc.gov.uk Email: andrew.baird@surreycc.gov.uk
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APOLOGIES FOR ABSENCE AND SUBSTITUTIONS
Minutes: Apologies were received from Ben Carasco and Rachel Turner. |
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MINUTES OF THE PREVIOUS MEETING: 3 July 2014
To agree the minutes as a true record of the meeting. Minutes: The minutes were agreed as a true record of the meeting.
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DECLARATIONS OF INTEREST
To receive any declarations of disclosable pecuniary interests from Members in respect of any item to be considered at the meeting.
Notes: · In line with the Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012, declarations may relate to the interest of the member, or the member’s spouse or civil partner, or a person with whom the member is living as husband or wife, or a person with whom the member is living as if they were civil partners and the member is aware they have the interest. · Members need only disclose interests not currently listed on the Register of Disclosable Pecuniary Interests. · Members must notify the Monitoring Officer of any interests disclosed at the meeting so they may be added to the Register. · Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest. Minutes: None were received.
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QUESTIONS AND PETITIONS
To receive an questions or petitions
Notes: 1. The deadline for Member’s questions is 12.00pm four working days before the meeting (11 September 2014). 2. The deadline for public questions is seven days before the meeting (10 September 2014). One has question has been received. 3. The deadline for petitions was 14 days before the meeting, and no petitions have been received. Additional documents: Minutes: 1. A public question was received from District Councillor Philippa Shimmin. The question and response were tabled at the meeting, and are enclosed within these minutes.
2. The Chairman invited Ms Shimmin to ask a supplementary question. A further question was asked and the Scrutiny Officer was to seek an answer from officers. The supplementary question and the response are also enclosed in these minutes.
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CHAIRMAN'S ORAL REPORT
The Chairman will provide the Committee with an update on recent meetings he has attended and other matters affecting the Committee. Minutes: Declarations of Interest: None
Witnesses: None
Key points raised during the discussion:
1. The Chairman provided the following oral report:
Major Changes at Surrey’s Acute Hospitals
The acquisition by Frimley Park Hospital of Heatherwood and Wexham Park Hospitals is progressing. The relevant CCGs have agreed to pick up the costs of the acquisition transaction. The merger of Royal Surrey County Hospital with Ashford and St Peter’s Hospitals is being pursued with enthusiasm. Surrey Health Scrutiny Committee has been asked to provide volunteers for the Merger Stakeholder Panel. The future of Epsom Hospital remains uncertain. The South West London health economy has been identified as one of 9 ‘challenged health economies’ in England. It is estimated to have a £500 million annual deficit. Epsom Hospital has to be considered to be at least in close orbit to that economy. Epsom Hospital’s deficit last year’s was £7.4 million. The aim is to break-even this financial year and to enter the process of becoming a Foundation Trust early in 2015. East Surrey Hospital continues to seek Foundation Trust status. The Hospital received a ‘Good’ rating from its CQC Inspection, but there still seem to be question marks over its projected financial position. Quality of Health Services
The impact of the Francis Report continues to be felt. As we heard at our Meeting of 30 May 14 the announced Inspections by the Care Quality Commission (CQC) have been broadened and deepened. Those of our Acute Hospitals that have been subject to the new Inspections have come through well. CQC has previously raised some concerns about Surrey and Borders Partnership (SABP) and has recently carried out a new style Inspection of SABP. SABP is the Trust that provides Mental Health Services in Surrey. We expect to be involved in an SABP Quality Summit. Integration of Health and Social Services
A major shift of emphasis in the integration process is towards enabling people to stay out of hospital as much as possible. The major key performance indicator from Central Government is the reduction in the number of unplanned admissions into hospital, with a target of 3.5% reduction year on year. The Clinical Commissioning Groups will move money from the Acute Hospitals towards Social Services and Community Care. As a consequence the Acute Hospitals will come under pressure to downsize by taking beds out of commission. This will have a major impact on the Acute Hospitals. The mechanism for managing this shift of funding in 2015/16 will be the Better Care Fund (BCF). Progress in planning the shift is slow with the CCGs understandably keen to know that the money lost from their budgets to Social Services will result in a compensatory reduction in demand on the Acute Hospitals.
Recommendations: None
Actions/ further information to be provided: None
Committee next steps: None
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INTEGRATION: COMMUNITY PROVISION IN THE HEALTH SYSTEM AND THE USE OF TECHNOLOGY
Additional documents: Minutes: Declarations of Interest: None
Witnesses:
Tricia McGregor, Managing Director, CSH Surrey Ian Wiles, Director of Operations, Virgin Care Philip Greenhill, Managing Director, First Community Health and Care Jan Don, Director of Service Development, First Community Health and Care Vernon Nosal, Acting Senior Manager Personal Care and Support, Adult Social Care
This item required the Committee to divide into three groups with each group being assigned a provider. This gave Members the opportunity to conduct in depth discussions with leading figures in the healthcare community in Surrey and develop a greater understanding of both the opportunities and challenges presented by integration and the use of technology for the provision of healthcare inSurrey.
Key points raised during the discussion
1. To preface the group discussions each of the providers gave a brief introduction to their report and gave the Committee a context for the environments in which they were working as well as some of the healthcare services they provided to the people of Surrey. The providers highlighted the challenges of providing frontline healthcare services and the increased pressure placed on providers both due to the emergence of more complex and demanding healthcare needs not just from the increasing elderly population but also from children being born with severe medical conditions that previously would have been fatal.
2. Following the conclusion of the discussions, a spokesman from each of the groups was asked to provide feedback on what members had learned about the process of integration for healthcare providers in Surrey as well as the obstacles they faced in ensuring that there were no gaps in the provision of healthcare services. Some common themes emerged from the feedback the most prominent of which was issues arising from the existing funding model which makes integration more difficult because of underlying differences in how different providers are funded. The incentives for these organisations are not presently aligned representing a barrier to integration. Moreover, the authorisation and regulatory framework which Acute Hospitals work under, MONITOR or the Trust Development Authority, can prevent them from engaging in systematic change especially where this has a significant impact on size, clinical standards and ultimately potential viability.
3. Clinical Commissioning Groups (CCGs) need to be proactive in influencing payments and in promoting the use of different commissioning models. They could, as has been done in the Guildford and Waverley area with the creation of an Integrated Care Organisation, consider the resources of the health system as a whole.
4. On the whole, providers reported good working relationship with Surrey CCGs at a strategic and operational level especially around the Better Care Fund but cautioned that cultural differences could impede delivery of the integration agenda. It was also suggested that specific funding was required to achieve large scale transformational change that enabled up-front investment rather than trying to establish very different services without the opportunity for testing/building the new system and clinical confidence. It was further highlighted that Members play an important role in influencing the integration agenda. ... view the full minutes text for item 6/14 |
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Additional documents: Minutes: Declarations of Interest: None
Witnesses: Bob Gardner, Karen Randolph
An update was provided on the latest developments regarding SECAmb’s (South-East Coast Ambulance Trust) proposed reorganisation of its Emergency Operations Centres (EOC). It was advised that representatives from SECAmb had stressed the need for a reorganised EOC given that they currently receive in excess of 9 million 999 and 111 calls annually and that within the next few years they would reach full capacity in terms of the number of calls that SECAmb’s current provision of EOCs can process. SECAmb had considered three potential options for meeting the projected increased in 999 calls: an incremental expansion and improvement of existing centres, building two new large centres or moving all centres to one large EOC. It was decided that the second option, building two large EOCs, was the best option as SECAmb was reluctant to centralise in one area in case of an event which could compromise the operational capacity of the EOC while it was felt that incremental updates and expansions of the existing EOCs would only be sustainable for so long. SECAmb had highlighted that they were currently in the process of locating suitable sites for the new EOCs and that conversations had taken place with staff to make them aware of the new arrangements, discuss arrangements about how they travel to the new site and to advise that there were be no redundancies as a result of the relocations of SECAmb’s EOCs. Furthermore, it was also advised that the new EOCs would help SECAmb to make a two-tiered system for dealing with 999 calls and 111 calls to ensure that they were given the appropriate priority status when being responded to by paramedics.
Key points raised during the discussion:
1. Members requested more information on the extent to which SECAmb used the ‘hear and treat method’ for dealing with some emergency calls. It was advised that this method was used for prioritising patients and ensuring that patients are directed to the most appropriate service. Paramedics have also been given increased powers to decide whether patients need to go to hospital or if they can be treated at home while Paramedics are also on-hand at EOCs to offer advice to 999 responders and ensure that patients are given increased support.
2. The Committee expressed some concern that the report didn’t include any details on SECAmb’s quality outcomes and requested further information on these for its EOCs. It was advised that these would be discussed at the next meeting of the Member Reference Group with a view to presenting these at a forthcoming Select Committee.
3. Concern was also raised as a result of the fact that 111 wasn’t mentioned in the report. It was indicated that the plan was to create a two-tiered system to allow the Trust to handle the increasingly complex and lenghty 999 calls during the development of the new EOCs as well as the 111 service.
4. Members also asked for more information on funding ... view the full minutes text for item 7/14 |
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RECOMMENDATION TRACKER AND FORWARD WORK PROGRAMME
The Committee is asked to monitor progress on the implementation of recommendations from previous meetings, and to review its Forward Work Programme. Additional documents: Minutes: Members requested the addition of an update regarding the outcome of the planned public engagement outlined in the presentation.
Recommendations:
None
Actions/ further information to be provided:
1. An update on the public engagement conducted by SECAMB will be added to the forward work programme.
Committee next steps:
None
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DATE OF NEXT MEETING
The next meeting of the Committee will be held at 10.00 am on Thursday 20 November 2014. Minutes: The Committee noted the next meeting would be held on 20 November 2014 at 10.00 am in the Ashcombe Suite.
Meeting ended at: 12.25 pm.
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