Agenda and minutes
PDF 136 KBVenue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN
Contact: Ross Pike or Andrew Baird Email: ross.pike@surreycc.gov.uk
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APOLOGIES FOR ABSENCE AND SUBSTITUTIONS
Minutes: Apologies were received from Mr Bill Chapman and Borough Councillor Rachel Turner.
Ben Carasco chaired the meeting. |
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MINUTES OF THE PREVIOUS MEETING:
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 received |
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QUESTIONS AND PETITIONS
To receive any questions or petitions
Notes: 1. The deadline for Member’s questions is 12.00pm four working days before the meeting (14 November 2014). 2. The deadline for public questions is seven days before the meeting (13 November 2014). 3. The deadline for petitions was 14 days before the meeting, and no petitions have been received. Minutes: None received |
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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: The Chairman sent his apologies for the meeting and so no oral report was given. A copy of the Chairman’s report is included below.
Chairman’s Report
Major Changes at Surrey’s Acute Hospitals The acquisition by Frimley Park Hospital of Heatherwood and Wexham Park Hospitals was completed on 1 October 2014. Examination of the plans to assure benefits for Surrey residents appears at Item 8 on the Agenda of the Health Scrutiny Committee of 20 November 2014.
At our meeting of 6 July 2014 the Committee heard from Andrew Liles of Ashford and St Peter’s Hospitals and Giles Mahony of Royal Surrey County Hospital that the hospitals are working towards a merger in June 2015. Approval from the Competition and Markets Authority (CMA) and from the regulator, Monitor, is expected to be achieved by the end of 2014. Work has begun on joint planning by lead clinicians to assure that benefits can be realised from the off. Tim Evans and Bill Barker are involved through the Public Stakeholder Panel. We expect to receive an update on the Business Plan for the merger most likely at the HSC meeting of 18 March 2015.
Care Quality Commission Inspections During the past year the Care Quality Commission (CQC) has published inspection reports on all five of our Surrey Acute Hospitals. All five hospitals have achieved a ‘Good’ rating or better, with Frimley Park being the first Acute Trust in England to achieve the ‘Outstanding’ rating.
The CQC has carried out an in-depth Inspection of 51 sites belonging to Surrey and Borders Partnership Trust (SABP). The Trust provides Surrey-wide high-end mental health, drug and alcohol abuse, and learning disabilities services. Tim Hall, Ross and I were invited by the CQC to a Quality Summit on 20 October to discuss the results of their inspection and how help could be provided to SABP to progress along its quality improvement pathway.
Other attendees at the SABP Quality Summit included representatives from Monitor (in the Chair); the NHS Surrey and Sussex Area Team; North East Hampshire and Farnham CCG (which commissions services from SABP on behalf of all of the Surrey CCGs); the council’s Adults’ and Children’s Services; and Hampshire County Council Adults’ Services.
I have offered SABP the opportunity to attend an HSC Meeting, possibly on 8 January 2015, so that the Committee can probe the observations that were raised by CQC and how SABP intends to respond to them.
Re-Commissioning of Musculoskeletal (MSK) Services for North West Surrey CCG North West Surrey Clinical Commissioning Group is in the early stages of considering holding a competitive tendering exercise for the design and implementation of an integrated Musculoskeletal (MSK) Service. The concept is for a single provider to reorganize the fragmented components which currently make up the MSK Service and thus improve the service for patients and also save money. As plans become clearer we will bring this to the Committee. |
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BETTER CARE FUND UPDATE
Purpose of the report: Scrutiny of Services and Budgets/ Policy Development and Review.
The plans for the Better Care Fund have been submitted and the Committee will review the details and scrutinise plans for delivery.
Additional documents: Minutes: Declarations of interest:
The Chair of Surrey Coalition of Disabled People informed the Committee that he is a Lay Member for Surrey Downs Clinical Commissioning Group (CCG) but that he was in attendance at the meeting representing the Surrey Coalition of Disabled People.
Witnesses:
Susie Kemp, Assistant Chief Executive, Surrey County Council Dr Andy Brooks, Chief Officer, Surrey Heath CCG and Co-Chair of Surrey Health and Wellbeing Board Alison Alsbury, Director of Commissioning, North West Surrey CCG Cliff Bush, Chair, Surrey Coalition of Disabled People
Key points raised during the discussion:
1. The Assistant Chief Executive of Surrey County Council highlighted that, through close collaboration between the Council and the CCGs, a comprehensive strategy had been developed for the delivery of the Better Care Fund (BCF) in Surrey. Of the £65 million of BCF funding for Surrey, it was highlighted that £25 million was being allocated to protect social care as part of the wider effort to manage the use of acute hospital care, specifically among frail and elderly residents where community-based care is often more appropriate. The Committee were advised that increasing the amount of care provided on a preventative or early stage basis can reduce the need for more complex and urgent care and would allow for better management of healthcare while also promoting better health and quality of life for people in Surrey.
2. The Committee learned that the success of the BCF would be measured by how outcomes had improved for residents through a set of nationally agreed metrics. Surrey-wide schemes such as Mission 90, an initiative designed to raise the average age of residents going into nursing homes from 87 to 90, would also be used to inform analysis on the implementation of the BCF. It was, however, stressed that each of the CCGs with their social care partners in the Local Joint Commissioning Groups (LJCGs) had developed their own local plans for implementing the BCF taking account of local demographics and requirements. The Surrey-wide BCF plan would be provide an overarching framework.
3. Members were advised that the BCF plan had been sent to the Department of Health for approval on 30 September 2014 and had been approved with some conditions. The governance framework for the delivery of the plan is currently in the process of being completed and the final plan will be submitted by 9 January 2015.
4. The Committee drew the witnesses’ attention to page 17 of the agenda and asked for assurance that the Adult Social Care Directorate and the CCGs would be able to deliver a ‘robust programme of management’ in the delivery of the BCF. The Assistant Chief Executive highlighted the importance of the Better Care Fund Board, which comprises key individuals from the Council as well as representatives from the CCGs, in coordinating the delivery of the BCF. It was advised that the metrics outlined in the presentation are the key measurements of success for the fund. The Assistant Chief Executive stated that she would circulate ... view the full minutes text for item 6/14 |
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PATIENT TRANSPORT SERVICE
Additional documents: Minutes: Declarations of Interest: None
Witnesses:
Geraint Davies, Director of Commercial Services, SECAmb Rob Mason, Head of Patient Transport Service, SECAmb Libby Hough, Customer Accounts Manager, SECAmb Alison Alsbury, Director of Commissioning, North West Surrey CCG Laurence Harvey, Head of Transport, North West Surrey CCG, Cliff Bush, Chair, Surrey Coalition of Disabled People Nick Markwick, Director, Surrey Coalition of Disabled People Jane Shipp, Engagement Manager, Healthwatch Surrey
Key points raised during the discussion:
1. The Director of Surrey Coalition of Disabled People provided the Committee with an insight into the experiences of those using the Patient Transport Service (PTS) and highlighted that, despite the changes which had been implemented by SECAmb, the system was still chaotic. Members were advised that care homes were having particular issues with delays in patient transport arriving to pick up residents causing them to be late for or miss important appointments. This negative patient experience of the PTS was also highlighted to the Committee by the Engagement Manager at Healthwatch Surrey who commented that it was alarming that 15 people per day were still experiencing long delays of over 4 hours when waiting to be picked up by the PTS. Although it was conceded that some improvements had been made in improving patient experience there were still significant issues which needed to be addressed. The Chair of Surrey Coalition of Disabled People recommended that the provision in the contract allowing for the PTS to be 15 minutes late when picking patients up should be deleted when the contract is retendered.
2. Members asked whether SECAmb analyses reasons for PTS being late to pick patients up. The Head of PTS advised that SECAmb does record and analyse reasons for lateness and that travel disruption presents significant challenges, especially in northwest Surrey. It was highlighted that, where possible, SECAmb tries to act on the reasons for delays, indicating that measures to mitigate the delays caused by last minute staff sickness had led to reductions in the number of delays resulting from this.
3. The Committee requested information on the terms of the contract and asked why SECAmb tendered for the contract given the challenges it has presented. The Director of Commercial Services at SECAmb conceded that they had experienced challenges in delivering the PTS in Surrey but advised that SECAmb had increased its funding of the PTS by 25% in order to improve their delivery of this service which meant that this contract was now running at a loss. Members were told that SECAmb had advised NW Surrey CCG, as the commissioning body, that they would be unable to continue with the contract in its current form when it is re-commissioned. The Head of PTS stressed to the Committee that SECAmb were committed to continuing to deliver patient transport services in Surrey but that the terms of the contract would need to be re-designed during the re-procurement process to allow them to deliver this service effectively. The Head of Transport for NW Surrey CCG informed ... view the full minutes text for item 7/14 |
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Following Monitor’s approval of Frimley Park’s acquisition of Heatherwood & Wexham Park Hospitals the Committee wishes to receive an update on the plans for the management of the new organisation and seek assurances on the benefits for Surrey residents and how risks will be managed. Minutes: Declarations of interest: None
Witnesses:
Jane Hogg, Integration Director, Frimley Health Foundation Trust (FT) Alison Huggett, Director of Quality and Nursing, Surrey Heath CCG Rosie Trainor, Interim Director of Quality and Nursing, North-east Hampshire and Farnham CCG
Key points raised during the discussion:
1. The Integration Director advised the Committee that, seven weeks on from the acquisition of Heatherwood and Wexham Park hospitals, the running of these new sites was progressing well. Members were informed that a new Operations Director had been appointed to work on improving the performance of the new hospital sites acquired while also ensuring that there was sufficient capacity across the executive team to safeguard maintaining the high standard of Frimley Park hospital. It was also highlighted that work was underway to introduce the devolved medical leadership model to Wexham Park hospital. The Committee was advised that best practice would be shared throughout the new Frimley Health NHS Foundation Trust to improve services across all of the hospital sites. It was highlighted, for example, that the strong plastic surgery and haematology departments at Wexham Park hospital would help to further improve those services at Frimley Park hospital.
2. The Committee requested information on how staff had responded to the acquisition. The Integration Director at Frimley Health FT advised the Committee that on the whole the staff had responded very well to the acquisition especially at Wexham Park hospital. Some reservations had been expressed among staff at Frimley Park who voiced concerns that the acquisition would lead to changes but stated that any changes that have or will take place are very limited.
3. Members asked about patient flow due to other mergers taking place in Surrey and requested details on how Frimley Health FT will work with the CCGs and other hospitals to ensure that patient flow is managed effectively. The Integration Director stressed that Frimley Health FT were happy to acquire the Heatherwood and Wexham Park hospital sites to provide the best opportunity to protect acute services in the Frimley area. The Committee was advised that the FT was in the process of starting a dialogue with other hospitals in Surrey to ensure that a balanced set of services are provided throughout the county.
4. The Committee asked how, with the same staff and infrastructure, Frimley Health FT aimed to raise standards at Heatherwood and Wexham Park hospitals especially for those patients who are transferred to either of these hospitals from Frimley Park. The Integration Director clarified that the aim was to deliver services locally and that patients would only be transferred from Frimley Park when the specialist nature or quality of treatment they can expect to receive for a specific medical issue is of a significantly higher quality at one of the acquired sites. Members were advised that plans were in place to improve the quality of services in key areas at the acquired hospitals such as reducing waiting and care referral times. Plans had also been formulated to bring staff on ... view the full minutes text for item 8/14 |
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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: Declarations of Interest: None
Witnesses:
Bob Gardner, Peter Hicks, Borough Councillor Karen Randolph Michael Gosling, Cabinet Member for Public Health
Key points raised during the discussion: 1. The Committee were provided with a brief update on the work of the Alcohol Member Reference Group. It was highlighted that members of this Reference Group had attended meetings with representatives from Public Health and Alcohol Concern to look at strategies for promoting a healthier relationship with alcohol amongst Surrey residents specifically through the Dry January initiative. It was advised that the support of the Communications department would be beneficial in order to successfully promote the Dry January initiative and the Cabinet Member for Public Health agreed to get in touch with the team and request their help in publicising Dry January. The Cabinet Member agreed that communications support was required to make the Dry January initiative a success and confirmed that he would speak to them about lending their support.
2. In response to a recommendation made at the meeting of the Health Scrutiny Committee on 17 September 2014, the Committee were informed that SECAmb’s new Emergency Operation Centres (EOC) would be funded by capital investment and that the lease for the current EOCs are due to expire in 2015/16.
3. The Cabinet Member for Public Health advised the Committee to take a look through the BCF plan to understand the difficulty of implementing the plan and the challenges which lie ahead. Members were also encouraged to explore the integration of Children’s health and social care which took place void of the impetus of BCF.
Recommendations:
• The Committee recommends that the Cabinet Member for Public Health asks the Communications department to publicise and promote the Dry January initiative.
Actions/ further information to be provided:
None
Committee Next Steps:
• The Committee to consider integrated Children’s health and social care commissioning in Surrey to further understand the developments needed to deliver the BCF for frail and elderly adults. |
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DATE OF NEXT MEETING
The next meeting of the Committee will be held at 10.00 am on Thursday 8 January 2015. Minutes: The Committee noted its next meeting will be held at 10.00 am on Thursday 8 January 2015. |