Agenda and minutes
PDF 184 KBVenue: Ashcombe, County Hall. Kingston upon Thames, KT1 2DN
Contact: Ross Pike 020 8541 7368
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APOLOGIES FOR ABSENCE AND SUBSTITUTIONS
Minutes: Rachael I Lake
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MINUTES OF THE PREVIOUS MEETING: 2 JULY 2015
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 (9 September 2015). 2. The deadline for public questions is seven days before the meeting (8 September 2015). 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 Board with an update on recent meetings he has attended and other matters affecting the Board. Minutes: It is a pleasure to welcome back Cllr Rachel Turner from Reigate and Banstead Council to serve on the Board for a further 3 years.
Our New Title and Implications for our Work The addition of ‘Wellbeing’ to our Board’s name gives the opportunity to spread our wings a bit and we will be proceeding as follows:
The Local Health and Wellbeing Boards are a forum where many organisations responsible for wellbeing meet. We will be holding a private event with representatives from the 11 District and Boroughs early in 2016 to explore how best Members might become involved in these Health and Wellbeing Boards where they exist.
Transformation Programmes: Our Surrey CCGs are implementing transformation of their health services in partnership with their suppliers using the Models of Care recommended in the NHS 5 Year Forward View. We received an overview of these 5 Models at our Meeting of 21 May, where we also heard of Surrey Heath CCG’s intention to explore the Multi-speciality Community Providers (MCP) route. Earlier we had a presentation on the Vanguard Integrated Primary Care and Acute Systems (PACS) programme that is being led by North East Hampshire and Farnham CCG.
We will be asking for involvement when these and other Transformation Programmes are well under way. We have invited the Vanguard PACS programme team back to the Board next year.
Progress on the
Better Care Fund
Scrutiny of Mental Health A number of partners have made a commitment under the Mental Health Crisis Concordats to work together to prevent mental health crises and to ensure that people get treatment no matter where they make contact. These partners include: Surrey County Council; the Clinical Commissioning Groups; Surrey and Borders Partnership, Surrey Police and South East Coast Ambulance service. Following a preparatory all Member Seminar on the subject, this Board will be joining with the Social Care Services Board and the Police and Crime Panel in joint scrutiny of mental health in Surrey. Three joint sessions are planned in the remainder of 2015, 2 of which we will be hosting.
It will be critical for the financial position of the CCGs that attendances at A&E and unplanned admissions are held in check this coming Winter. We will hear more on this topic at Item 6 today.
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NORTH WEST SURREY URGENT CARE SYSTEM WINTER RESILIENCE
Purpose of the report: Scrutiny of Services
The Wellbeing and Health Scrutiny Board requested a further update from North West Surrey system health partners, on the steps taken in the wake of the 2014/15 challenges to minimise the future need to declare an internal Major Incident at Ashford & St. Peter’s. The Board also requested an outline of the actions taken to reinforce resilience of the urgent care system in North West Surrey. Minutes: Declarations of interest:
None
Witnesses:
Julia Ross, Chief Executive, North West SurreyClinical Commissioning Group
Suzanne Rankin, Chief Executive, Ashford & St Peter’s Hospitals NHS FT
Shelley Head, Area Director, Adult Social Care
James Kraft, Managing Director, Virgin Care
James Thomas, Head of Urgent & Emergency Care
Key points raised during the discussions:
1. The Head of Urgent & Emergency Careintroduced the item to the Board by stating additional resources would be applied this winter and that would include additional GP and Care Home provision. It was added that the CCG has invested £320K in a Care Home Support Team to support care homes in the upcoming winter period. It was questioned whether North West Surrey can provide the resources required, including additional Care Home services and paramedic practitioners, as the demand for skilled staff is so high. The Area Director advised the Board that funding is needed for different types of training and that a campaign to promote and incentivise caring careers in conjunction with Virgin Care had been devised. The Area Director also advised the Board that Adult Social Care were working with the CCG to challenge traditional methods around discharge to assess
2. The Board inquired when the results of the system’s actions would be revealed. The witnesses stated that the preparation for winter 2015 is on target and that health and social care providers were in a better position than last year to meet demand. They were able to identify future demand spikes because of an IT system that provided real-time data and allowed for information to be shared between system leaders.
3. Clarification was sought on the Intelligence Based Information System ‘IBIS’ a patient records system supported by the Ambulance Trust to allow their crews to have patient care records on the ground. Additionally, the Board were advised that a new system - Almanac - that collects outcome data in one place and could show delayed processes across the whole system for example. By using this system it was seen as integrated and developed as leaders could intervene collectively to surges in demand. This system was developed for under pressure systems and is currently being used in Brighton as well.
4. The Vice-Chairman queried whether the system’s goal for this winter was to avoid a major incident. It was stated that their intention was to stop system failing in terms of quality and safety and if they had to, leaders would be prepared to declare a major incident again even though that is undesirable. The CCG Chief Executive highlighted to the Board that the system was better at identifying future demand and that the big challenge was quality of serviceover public holidays. In 2014 pressure fell mostly on hospital and ambulance services, the difference in 2015 was the organisation were partners and have a agreed new process for extreme situations: ‘beyond black’ this allows the four system leaders to create one command centre to manage the system.
5. The Chief Executive of Ashford & St. Peter’s NHS ... view the full minutes text for item 14/15 |
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RESPONSES TO A&E EVIDENCE REQUEST
The responses to this Board’s request for evidence on the resilience of the other urgent care systems in Surrey have been included here as part of its consideration of item 6. Additional documents: Minutes:
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SURREY DOWNS CCG COMMUNITY HOSPITAL SERVICES REVIEW
Purpose of the report: Scrutiny of Services
The process of the Community Hospital Services Review has included membership from the Wellbeing and Health Scrutiny Board, as part of its Programme Board. That Board has approved the draft outcomes report. This report is to gain Wellbeing and Health Scrutiny Board approval on the process conducted within the review, with which the final outcomes have been reached, and to receive additional comments from members in regards to the report. Additional documents: Minutes: Declarations of interest:
None
Witnesses:
Dr Claire Fuller, Clinical Chair
James Blythe, Director of Strategy and Commissioning
SuziShettle, Head of Communications and Engagement
Key points raised during the discussions:
1. The Director of Commissioning & Strategy discussed with the Scrutiny Board the CCG Governing Body’s recommendation to proceed to public consultation on options for change following the Community Hospital Services Review process. Members of the Scrutiny Board were part of the Programme Board for the review and engaged with the CCG and the public throughout the process. These Members advised the Scrutiny Board that the process was open and transparent and that they were supportive and assured of the review undertaken by the CCG.
2. The Board asked how the council’s Adult Social Care Directorate had been involved in the review. The Director of Commissioning & Strategy stated that Social Care representatives had attended engagement events during the review and that Social Care staff will be directly involved in Surrey Downs’ community hubs. Additionally, the County Council’s Area Director for Mid-Surrey’s views had been reflected in the final report.
3. Answers were sought about the future consultation plan for the general public. The CCG stated that the relative strengths and weaknesses of the options for change will need to be discussed with the public. The Board were told that the CCG were happy to reflect feedback and explain the wider context of outpatient services in the Surrey Downs area in the public consultation document as per the Board’s advice but that, on the whole, awareness of other out-of-hospital services was high among residents.
4. The Board noted that the CCG currently faced considerable financial pressures and asked whether this had influenced the review. The CCG explained that four community hospital wards were not sustainable for the needs of their population, which is why a three ward model is recommended following the review. The property services budget for the sites was £4.8 million per annum while population growth figures for people over 65 years have reached 6% each year, stretching the financial package. However, the Director of Commissioning & Strategy emphasised that the CCG were not proposing to reduce spend on community hospital services as a result of the review.
Recommendations:
The Board:
· Approves of the review process undertaken by Surrey Downs CCG.
· Requests that it continue to be involved with the review process by scrutinising the CCG’s public consultation plans through a sub-group of Members - Tim Hall, Lucy Botting, Karen Randolph and Tina Mountain
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UPDATE FROM SURREY'S HEALTH AND WELLBEING BOARD
Purpose of the report: Scrutiny of Services and Budgets
To update the Scrutiny Board on the continued development and work of Surrey’s Health and Wellbeing Board. Minutes: Declarations of interest:
None
Witnesses:
Helyn Clack, Co-Chair of Health and Wellbeing Board and Cabinet Member for Wellbeing and Health
Liz Lawn, Co-Chair of Health and Wellbeing Board and Clinical Chair, North West Surrey Clinical Commissioning Group
Key points raised during the discussions
1. The Cabinet Member for Wellbeing and Health advised the Board that there had been vast improvements in working together in the health and social care system in the last two years. The Co-Chairs were asked about the work the Health and Wellbeing Board has done on children’s mental health. They referred to current countywide re-procurement of the Child and Adolescent Mental Health Services (CAMHS) which demonstrates the improvement in working together between health and social care. It was suggested that a benefit of having clinical leads involved in the re-specification of CAMHS is the role of GPs is marked. However, they agreed there is a relative low level of support and funding for children and young people with mental health issues including eating disorders.
2. The Board inquired about the involvement of District & Borough Councils and health and social care providers with the Surrey Health and Wellbeing Board. The Co-Chairs advised that the relationship varies with the districts and boroughs, links have often been made through individuals rather than in formal ways. They also stated that the Districts and Boroughs were all represented on the Local Joint Commissioning Groups. Regarding providers, the Co-Chair felt that the Transformation Boards were the best forum to involve providers and outlined the problem of effectiveness if the Health and Wellbeing Board’s membership was as numerous as these other Boards – there was a benefit in maintaining a strategic focus.
3. The Cabinet Member for Wellbeing and Health stated that participation was welcomed at the Surrey Health and Wellbeing Board and updated Members that she had been looking at how different boards across the country are working and hopes to convene a group of Chairs through the LGA to discuss best practice.
4. The Co-Chairs were asked about the Surrey priorities for children and young people. Members were advised that the board’s strategic plan was taking a overview of the Ofsted improvement plan and were assured of the early years and safeguarding arrangements with the Co-Chair adding that there was more confidence in the operation of children’s safeguarding now but that more work was required on the early help offer.
5. Members asked about the success of the Health and Wellbeing Board’s prevention activities. It was suggested that the plan focuses on the wider determinants not just ill-health prevention, such as Air Pollution. The Board suggested that the Co-Chairs discuss with the Director of Public Health how to strengthen these plans.
Recommendations:
The Board recommends that: · It receives a further update from the Health and Wellbeing Board on the progress against its strategic priorities and any possible changes to how it operates in 12 months time.
· The Co-Chairs discuss with the Director of Public Health how the Health and Wellbeing Board ... view the full minutes text for item 17/15 |
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JOINT COMMISSIONING OF SPEECH AND LANGUAGE THERAPY SERVICES FOR CHILDREN AND YOUNG PEOPLE
Purpose of the report: Scrutiny of Services
The purpose of the report is to provide an update on the Speech and Language Therapy Commissioning Strategy and the new service delivery model. Additional documents: Minutes: Declarations of interest:
None
Witnesses:
1. Anne Breaks, Head of Children’s Commissioning (Community), Guildford and Waverley Clinical Commissioning Group
Key points raised during the discussions
1. The Head of Children’s Commissioning introduced the report by updating the Board on the work undertaken to jointly commission speech and language and seeking the Board’s view on the level of engagement with stakeholders. A Member expressed views regarding the problems with speech and language therapy in Surrey. They stated that parents often need to get on the ladder early to ensure their children receive the required therapies. The Board was aware of some patients who had waited up to a year to access services. The Board were advised that the changes to the services would see CCGs redirecting funding from schools to early years boosting access and reducing the need for an intervention at school age
2. Regarding the joint commissioning process the Board asked why it has taken two and half years to get to the point of implementation. The Head of Children’s Commissioning expressed that she appreciated it had taken a long time. It was explained that there was a long process to organise the joint system and that they hoped to avoid any delays to the implementation of the new model.
3. It was suggested that television could help with speech and language therapy access issues, however, the Head of Children’s Commissioning advised that this would not be successful for most children especially those with specialist needs. The Head of Children’s Commissioning reassured the Board that staffing in speech and language therapy services was better than in other sectors rather it has been funding that has been the main issue although schools have always been able to buy in therapies over and above their core offer.
4. The Board were advised that they were 4,016 referrals to speech and language therapy in 2014 against a combined budget of £4.1 million which is spent across the Surrey County Council and the CCG. The plan for the future was to make the service more accessible and user friendly for example using a phone hotline to provide parental reassurance about child development and prevent children needing therapy in the future. Therapy is being introduced into schools as a process of education. However it was stated by an officer that the state of Primary Care in Surrey is below average.
Recommendations:
· The Board endorses the engagement work undertaken by the council and CCG and supports the joint commissioning of speech and language therapy.
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RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME
Purpose of the report: Scrutiny of Services and Budgets/ Policy Development and Review.
The Board will review its Recommendation Tracker and draft Work Programme. Additional documents: Minutes: Declarations of interest:
None
Witnesses:
None
Key points raised during the discussions:
None
Recommendations:
None
Actions/ further information to be provided:
None
Board next steps:
None |
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DATE OF NEXT MEETING
The next meeting of the Board will be held at 10.30 am on 12 November 2015. Minutes: The Board noted its next meeting will be held at 10.30 am on Thursday 12 November 2015 |