Agenda and minutes

Health, Integration and Commissioning Select Committee
Friday, 8 March 2019 10.00 am

Venue: Ashcombe Suite, County Hall, Kingston upon Thames, Surrey KT1 2DN. View directions

Contact: Huma Younis  Email: huma.younis@surreycc.gov.uk

Items
No. Item

22.

Apologies for Absence and Substitutions

    To report any apologies for absence and substitutions

    Minutes:

    Apologies were received from Mr Tim Oliver, Mr Graham Ellwood, Mr Darryl Ratiram and Ms Rachel Turner.

    Mr Tim Hall acted as a substitute for Mr Graham Ellwood.

    Ms Fiona White entered the meeting at 10:20am

23.

Minutes of the Previous Meeting: 7 November 2018 pdf icon PDF 294 KB

24.

Declarations of Interest

     

    All Members present are required to declare, at this point in the meeting or

    as soon as possible thereafter:

     

    i.       any disclosable pecuniary interests and / or;

     

    ii.      other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting

     

    NOTES:

     

    ·        Members are reminded that they must not participate in any item where they have a disclosable pecuniary interest;

     

    ·        as well as an interest of the Member, this includes any interest, of which the Member is aware, that relates to the Member’s spouse or civil partner (or any person with whom the Member is living as a spouse or civil partner); and

     

    ·        Members with a significant personal interest may participate in the discussion and vote on that matter unless that interest could be reasonably regarded as prejudicial.

     

    Minutes:

    There were none.

25.

Questions & Petitions

    To receive any questions or petitions

     

    Notes:

     

    1.    The deadline for Member’s questions is 12.00pm four working days before the meeting (Monday 4 March 2019).

     

    2.    The deadline for public questions is seven days before the meeting (Friday 1 March 2019).

     

    3.    The deadline for petitions was 14 days before the meeting, and no petitions have been received.

    Minutes:

    There were none.

     

26.

Response from the Cabinet to Issues Referred by the Select Committee

27.

South East Coast Ambulance Service Update pdf icon PDF 1 MB

    Purpose of the Report: This report updates the Committee on the South East Coast Ambulance Service, with special focus on the recent CQC report, Executive leadership development, performance reporting and associated strategic operational updates, alongside other local performance and development initiatives for Surrey.

     

    Minutes:

    Declaration of Interests:

     

    None

     

    Witnesses:

     

    Helen Wilshaw-Roberts, Strategy & Partnerships Manager – West, SECAmb

    Steve Emerton, Executive Director of Strategy and Business Development, SECAmb

    Andy Cashman, Regional Operations Manager: West, SECAmb

    Sumona Chatterjee, Executive Director of Strategic Commissioning, Surrey Heartlands CCG

    Matthew Parris, Healthwatch Surrey

     

    Key points raised during the discussion:

     

    1. The report was briefly introduced by the Executive Director of Strategy and Business Development who explained that the Trust had moved from an Inadequate to a Requires Improvement Care Quality Commission (CQC) rating.
    2. Witnesses were asked for an update on the new executive team employed by the Trust. It was explained that the previous Chief Executive, Daren Mochrie, had taken on a new role and Dr Fionna Moore would be acting as the SECAmb Interim Chief Executive. A new Chief Executive had been appointed and the Executive Director of Strategy and Business Development would update the Committee on the progress of this appointment in due course.
    3. It was confirmed that following the Demand and Capacity Review, it was recognised that a significant amount of investment was required to see improvements in the Trust. A contract variation agreed with the commissioners has placed a significant investment in the Trust for 2018 / 2019 and continues into 19/20 and 20/21. The investment in the Trust is dependent on the current contract review process and would be around £34-43million growth per annum over the next two years
    4. It was queried how much emphasis was given to triage by the Trust as it seemed to work well with the Crawley Ambulance triage programme. The Strategy & Partnerships Manager – West explained that the Crawley Ambulance triage programme had been successful in helping with the current gap in crisis response teams and the ability for an emergency response for people suffering a mental health crisis. The model consists of an advanced mental health practitioner and a paramedic that respond to calls. The result had been effective assistance had been provided and the Trust was working with Sussex Partnership and Foundation Trust to assess the most appropriate model of care for people experiencing such emergency crisis - this would then be assessed for wider rollout requirement further across Surrey and Kent.
    5. It was explained that the Targeted Dispatch Model would ensure the right resources get to the right places and people. There was a concern there will be a greater number of people being conveyed to the acute centres as resources available to the Trust improve. It was added that there were now midwives in the control centre environment for the Surrey Heartlands area which would reduce the number of conveyances to hospitals and this would be extended to Sussex and Kent in due course.

     

    Zully Grant-Duff arrived at the meeting at 10.35am

     

    1. It was queried what issues were stopping the Trust from improving ambulance response times and how these were being tackled. The Regional Operations Manager – West explained that the investment secured had enabled the Trust to secure additional resources and make improvements. The demands  ...  view the full minutes text for item 27.

28.

Draft Joint Health and Wellbeing Strategy for Surrey pdf icon PDF 299 KB

    Purpose of the Report: This report provides the Select Committee with the opportunity to consider and comment on the draft Joint Health and Wellbeing Strategy for Surrey.

     

     

    Additional documents:

    Minutes:

    Declaration of Interests:

     

    None

     

    Witnesses:

     

    Matthew Tait, Joint Accountable Officer, Surrey Heathlands ICS

    Helen Atkinson, Executive Director of Public Health

    Matthew Parris, Healthwatch Surrey

     

    Key points raised during the discussion:

     

    1. It was explained that the draft Joint Health and Wellbeing Strategy for Surrey was currently out for public engagement and the purpose of the meeting was for the Committee to comment on the draft strategy as well as to put forward specific questions.
    2. There was concern around the governance arrangements as part of the monitoring of the strategy delivery. Members commented that there did not seem to be clear lines of accountability within the strategy for the outcomes identified. The Executive Director of Public Health stated that the governance for the draft strategy sat with the Health and Wellbeing Board which both ICSs, Surrey Heartlands and Frimley Health and Care, and the East Surrey & Sussex STP are Members of. Work would be undertaken over the next month to collate engagement feedback and map out priorities alongside existing provision. This mapping of services will be used to review current governance arrangements. The final strategy will be signed off by the Health and Wellbeing Board in April. Sponsors from the Board would be sought to champion priorities and outcomes within the strategy. 
    3. The Joint Accountable Officer reassured the Committee that work on governance within the strategy was Surrey-wide. The officer was keen to ensure the right challenge with regards to responsibility for delivery was in place alongside the strategy.
    4. The Joint Accountable Officer stated that the deliverables in the strategy were cross-organisation and the challenge would be how to get stakeholders working together in partnership. It was added by the Executive Director of Public Health that there had been unprecedented partnership working when developing the strategy.
    5. In regard to NHS property, the Joint Accountable Officer explained that the culture of work across the NHS had improved and this would support any property discussions taking place. Devolution would allow for more discussions to take place around NHS property decision making as so far limited progress had been made.
    6. It was queried what steps would be taken to ensure the strategy is delivered to residents on the ground. The Joint Accountable Officer stated that by having a better joined up strategy, outcomes for the population in Surrey would be improved. Challenges around mental health had been raised but working together had resulted in a better approach and better outcomes. The Executive Director of Public Health stated that the strategy was a long term plan which would target deprived groups within the population.
    7. A concern was raised around the five population groups contained within the draft strategy and in particular the fact that people with mental health were not specifically identified as one of the five population groups. It was added that the system capabilities section of the draft strategy was difficult to grasp with many high level statements being made.
    8. Members recognised that the overall responsibility of the draft strategy sat with the Health  ...  view the full minutes text for item 28.

29.

Substance Misuse Service Report pdf icon PDF 235 KB

    Purpose of the Report: In July 2018, Surrey County Council implemented changes to the commissioning of Substance Misuse treatment following a review of these services. For the Select Committee to consider the progress made in the changes to the adult substance misuse treatment system.

     

    Additional documents:

    Minutes:

    Declaration of Interests:

     

    None

     

    Witnesses:

     

    Martyn Munro, Senior Public Health Lead, Surrey County Council

    Helen Atkinson, Executive Director of Public Health

    Sinead Mooney, Cabinet Member for Adults and Public Health

    Katy Matthews, Substance Misuse Service Manager, Surrey and Borders Partnership

    Sue Murphy, CEO, Catalyst

    Matthew Parris, Healthwatch Surrey

     

    Key points raised during the discussion:

     

    1. It was queried what impact out of county services have had on patients since the closure of Windmill House and what steps were being taken to ensure these out of county services were being monitored. The Substance Misuse Service Manager explained that the model of detoxification had changed from 1 July 2018 and the new model included a mix of ambulatory and out of county services. Out of county services had been spot purchased from Bridge House in Kent, which has received an outstanding grading from the CQC and has a good reputation for providing outstanding services. It was added that for patients who required more than an hour’s travel to reach ambulatory services, spot purchasing from Bridge House could be organised, although this was considered on a case by case basis.
    2. A Member of the Committee queried what lessons the adult substance misuse treatment team had learnt from the integration of sexual health and HIV services in Surrey as mentioned in the introduction of the report. The Executive Director of Public Health stated that a great amount of work had been done to consult with service users and patients. Joint work had also been undertaken with NHS commissioners and Providers. The Cabinet Member added that the work of the sexual health services task group had a positive impact on the work of the team, ensuring that discussions with people impacted by the service took place.
    3. There was a discussion around the increased use of opiates in the USA. It was queried how resilient the service would be if there was an increase in opiate use in Surrey. The Senior Public Health Lead explained that locally the medicine management team had not highlighted any hotspots for opiate use in Surrey. Work was also being undertaken with local acute teams to understand how best to work collaboratively to support teams further in the field of opiate use. Nationally access to opiate treatment was at a decline but in Surrey there has been an increase in the number of people accessing opiate treatments. It was added that there were a number of satellite prescribing services for opiate users in Surrey although there was an ongoing challenge with recruiting prescribing staff.
    4. The Healthwatch representative explained that a number of positive comments had been received on the i-access treatment with the needs of service users being adequately met. There was some concern around a single point of contact for service users and also some anxiety around the move of in-patient services, although this was not deemed to be detrimental. Overall the comments from service users was very positive.

     

    Dr Bill Chapman left the meeting at 12.52.

     

    1. It was explained that  ...  view the full minutes text for item 29.

30.

Health, Integration and Commissioning Select Committee Bulletin pdf icon PDF 52 KB

    Purpose of the Report: To update Members of the Committee on key issues relating to the delivery of healthcare services in Surrey and detailing work underway to scrutinise these.

     

    Additional documents:

    Minutes:

    Declarations of Interests:

     

    None

     

    Witnesses:

     

    None

     

    Key points raised during the discussion:

     

    1.    The Chairman agreed to consider the bulletin before the forward plan item as the content on the bulletin could potentially have an impact on the items to be considered by the Committee going forward.

    1. The item was introduced by the Chairman of the Select Committee who advised that the bulletin was a means of keeping Members updated regarding the work she had undertaken between Select Committee meetings.

    3.    There were no comments on the bulletin.

     

    Actions/ further information to be provided:

     

    None

     

    RESOLVED:

     

    The Health, Integration and Commissioning Select Committee noted the Select Committee bulletin.

     

31.

Recommendations Tracker and Forward Work Programme pdf icon PDF 56 KB

32.

Mapping the Patient's Journey through Adult Mental Health Services in Surrey- Task and Finish Group Scoping Document pdf icon PDF 57 KB

    Purpose of report: For the Select Committee to review and comment on the attached task and finish group scoping document.

     

    Additional documents:

    Minutes:

    Declarations of Interest:

     

    None

     

    Witnesses:

     

    None

     

    Key points raised during the discussions:

     

    1.    The Vice-Chairman explained that as the Democratic Services Officer who worked on the Committee had left the organisation, the timetable included within the scoping had been pushed back. Recruitment was underway for committee support. A meeting with SaBP has been set up for April to discuss pathways in more detail.

    2.    The importance of this piece of work was reiterated by the Chairman.

    3.    The Healthwatch representative agreed that Healthwatch would be happy to support this task group in whatever way it can.

     

    Actions/ further information to be provided:

     

    None

     

    RESOLVED:

     

    The Health Integration and Commissioning Select Committee noted the task and finish group scoping document.

     

33.

Date of the Next Meeting