Agenda and draft minutes

Health, Integration and Commissioning Select Committee
Wednesday, 7 November 2018 10.00 am

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

Contact: Andrew Baird  Email: andrew.baird@surreycc.gov.uk

Items
No. Item

10.

Apologies for Absence and Substitutions

11.

Minutes of the Previous Meeting: 4 July 2018 pdf icon PDF 74 KB

12.

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

13.

Questions & Petitions pdf icon PDF 178 KB

    To receive any questions or petitions

     

    Notes:

     

    1.     The deadline for Member’s questions is 12.00pm four working days before the meeting (1 November 2018).

     

    2.     The deadline for public questions is seven days before the meeting (31 October 2018).

     

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

    Minutes:

    Three public questions were submitted individually to the Committee by Liz Sawyer, Stephen Fash and Sheila Boon. Responses to each of these questions were tabled at the meeting and are attached as Annex 1 to these minutes.

14.

Response from the Cabinet to Issues Referred by the Select Committee

15.

Ten Year Strategic Plan for Surrey pdf icon PDF 92 KB

    Purpose of the Report:

     

    This report will give Members an opportunity to consider areas of focus for the ten year strategic plan for Surrey and to agree an approach for ongoing scrutiny of the plan as it develops over the coming months.

    Minutes:

    It was agreed that, due to the availability of officers, this item would be considered before Item 6.

     

    Declarations of interests:

     

    There were none

     

    Witnesses:

     

    Helen Atkinson, Executive Director of Public Health, Surrey County Council

     

    Nick Jones, PwC

     

    Tim Oliver, Cabinet Lead Member for People

     

    Matthew Parris, Deputy CEO, Healthwatch Surrey

     

    Key points raised during the discussion

     

    Mr Graham Ellwood entered the meeting at 10.11am

     

    1.     The Committee received an introduction to the report from witnesses who informed Members of the reasons why a Ten Year Strategic Plan for Surrey was being developed and the steps that were being taken in order to build a consensus around shared priorities for the health and care system in the County. These priorities would be informed by extensive engagement with stakeholders and the public as well as from the findings of the intelligence-gathering programme being conducted by PwC.

     

    2.     Clarity was sought from Members of the Committee on whether the Strategic Plan would focus exclusively on improving the health and wellbeing of Surrey residents. Members heard that the PwC had spoken to a range of partners during the intelligence-gathering exercise which had included seeking the views of public sector partners beyond health and social care. The Strategic Plan would form part of the new ‘Vision for Surrey in 2030’ which had been developed by Surrey County Council as part of a single plan to align priorities for all public sector investment in Surrey.

     

    3.     Members requested further information on how the Strategic Plan would interact with the three Sustainability and Transformation Partnership (STPs) footprints that are wholly or partly in Surrey. The Committee was informed that the Plan would sit above STPs and would be owned by the Health and Wellbeing Board in accordance with its statutory requirement to produce a Joint Health and Wellbeing Strategy. The membership of the Health and Wellbeing Board was being reviewed to incorporate a much wider range of partners whose voices would taken into account on delivery against agreed outcomes.

     

    4.     Discussions turned to the length of time that it would take for efforts to improve population health in Surrey to be realised with some Members suggesting that it could take a generation or more to mitigate demand arising from poor lifestyle choices. The Committee heard that it was vital to focus on prevention and early intervention to ensure that the health and social care system can manage demand within the budget envelope available and to reduce health inequalities in the County. Witnesses highlighted that evidence collated by PwC and contained within Surrey’s Joint Strategic Needs Assessment had shown that prevention could have a significant impact in the medium term.

     

    5.     The Committee highlighted the importance of engaging with the voluntary, community and faith sector (VCFS) as well as with local businesses regarding the development of priorities for the Strategic Plan. Members were advised that PwC had engaged with VCFS organisations seeking their initial view on the plan but that further engagement work would be conducted with  ...  view the full minutes text for item 15.

16.

Health Integration and Commissioning Select Committee Bulletin pdf icon PDF 53 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 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.

     

    2.     A Member enquired about the work of the Improving Healthcare Together 2020 – 2030 Sub-Committee and asked how Members of this Sub-Committee were mitigating the bias of the Chief Executive of Epsom and St Helier University Hospitals Trust. The Chairman advised that the Improving Healthcare Together 2020 – 2030 Programme was the responsibility of commissioners and the Sub-Committee had engaged only with the commissioners which meant that there had been no contact with the Chief Executive of the Trust.

     

    Actions/ further information to be provided:

     

    None

     

    RESOLVED:

     

    None

17.

Working with Patients to Improve Mental Health Services: An Update on Recent Work by Healthwatch Surrey pdf icon PDF 146 KB

    Purpose of the Report:

     

    To summarise what Healthwatch Surrey is hearing and doing in relation to mental health services. It also makes a recommendation about how the committee and Healthwatch Surrey might work together on this topic in the future.

     

    Additional documents:

    Minutes:

    Declarations of Interests:

     

    A non-pecuniary interest was declared by Bill Chapman who advised that he was a Governor of Surrey and Borders Partnership NHS Foundation Trust.

     

     

    Witnesses:

     

    Tumi Banda, Associate Director for Working Age Adult Inpatient Services, Surrey and Borders Partnership NHS, Foundation Trust

    Matthew Parris, Deputy CEO, Healthwatch Surrey

    Lorna Payne, Chief Operating Officer, Surrey and Borders Partnership NHS Foundation Trust

    Justin Wilson, Medical Director, Surrey and Borders Partnership NHS Foundation Trust

    Key points raised during the discussion:

    1.     The Committee received an introduction on the role of Healthwatch Surrey (HWSy) within the health and social care system in the County. Members heard that Healthwatch used various methods to gain insights into patient experiences around the delivery of specific services making recommendations to commissioners and providers in response to these.

     

    2.     Further information was also provided on the Enter and View visit to the Abraham Cowley Unit (ACU), a mental health inpatient unit operated by Surrey and Borders Partnership NHS Foundation Trust. The Committee heard the reasons behind HWSy’s decision to invoke its statutory power to undertake an Enter and View visit at the unit and were informed of the methodology used and engagement conducted by HWSy to collect evidence during their visits. SABP had been very responsive in seeking to address the problems identified by HWSy officers during their visit but that there appeared to be some long-term challenges that it was necessary for the Trust to address regarding its inpatient provision. The Committee was informed that staffing levels and the environment were the two key challenges at the ACU.

     

    3.     Representatives from SABP were given the opportunity to respond to the findings of the Enter and View Report. It was acknowledged that the capacity to recruit and retain good quality nursing staff as well as the environment created significant challenges for the provision of inpatient care at the ACU. Members heard that plans were being developed to improve the quality of the environment in working age adult wards through rebuilding and refurbishment alongside a building programme to improve inpatient mental health service units across the county. The Committee was advised that SABP had commissioned an independent review to make recommendations on how the Trust could improve patient experiences at the ACU.

     

    4.     Discussions turned to the use of dormitories to house patients at the ACU and the Committee was advised that many patients had reported that sleeping in dormitories had impacted negatively on them. Members of the Committee requested that SABP commit to a clear timescale on when dormitories would be replaced with single occupancy rooms. Representatives from SABP acknowledged that dormitories were not optimum for accommodating mental health inpatients but stressed that the sums associated with refurbishing the ACU were significant. The Trust was progressing its plans to have three mental health inpatient hospitals in Surrey but already had funding in place to refurbish the ACU irrespective of whether they received financial backing for the three hospital solution. Members were advised that, when taking demand into  ...  view the full minutes text for item 17.

18.

Sexual Health and HIV Services Contract pdf icon PDF 247 KB

    Purpose of the Report:

     

    For the Health, Integration and Commissioning Select Committee to review performance against the Sexual Health and HIV Services contracts. Members will also be given the opportunity to review progress made by Central and North West London NHS Foundation Trust, NHS England and Surrey County Council  in implementing the recommendations made by the Committee at its meeting on 4 July 2018.

    Additional documents:

    Minutes:

    Declarations of Interests:

     

    None

     

    Witnesses:

     

    Lisa Andrews, Senior Public Health Lead, Surrey County Council

    Dr Simon Edwards, Clinical Director, Central and North West London NHS Foundation Trust

    Ruth Hutchinson, Deputy Director of Public Health, Surrey County Council

    Fiona Mackison, Service Specialist, NHS England Specialised Commissioning

    Matthew Parris, Deputy CEO, Healthwatch Surrey

    Stephen Tucker, Deputy Service Director, Sexual Health and HIV, Central and North West London NHS Foundation Trust

    Key points raised during the discussion:

     

    1.     The Committee acknowledged that significant improvements had been made in the provision of Sexual Health and HIV Services in the intervening period since the Service had last been scrutinised. Concern was, however, expressed about access into the service for those who feel less comfortable booking appointments or requesting testing kits online. Members were advised that online was one of a number of access points into the Service for residents and that Central and North West London NHS Foundation Trust (CNWL) had adapted services to ensure accessibility.

     

    2.     Members sought clarity on progress that had been made to resolve some of the initial issues experienced by the service when the contract commenced with CNWL such as disabled access to clinics, increase in GP referrals and problems with the telephone system. The Committee heard that steps had been taken to address these issues in consultation with patients and stakeholders. This had included work with Disabled Go and Surrey Coalition of Disabled People who had made recommendations regarding how to improve the accessibility of clinics to those with disabilities.

     

    3.     Discussions turned to the availability of services through the hub, spoke and outreach model implemented by CNWL. All of the spokes were fully operational and consultants had all been trained to treat both GUM and sexual health conditions which meant that there was greater flexibility within the Service.

     

    4.     The Committee asked whether Sexual Health and HIV Services in Surrey were better than they had been before CNWL took over the contract in April 2017. Members were advised that the new service model offered a variety of access points into the service, in particular the use of online services to be able to cover the geography of Surrey. This meant that consultant time could be targeted more effectively towards those with the most acute conditions which was vital given the reduced financial envelope available to commission sexual health services. Witnesses also emphasised the challenges inherent in bringing three separate services together into a single Sexual Health and HIV Service for Surrey.

     

    5.     Members heard that HWSy had held an event at Buryfields Clinic in Guildford to find out more about the experiences of patients and that, among a very small sample, the majority who spoke to HWSy indicated that they were very happy with the services they had received. Some patients had, however, expressed concern about reductions in the number of Sexual Health Advisors. Representatives from CNWL stated that patients in HIV treatment who have an undetectable viral load could not pass on the virus and the service  ...  view the full minutes text for item 18.

19.

Response from NHS England Specialised Commissioning and Surrey County Council to Recommendations made by the Health Integration and Commissioning Select Committee pdf icon PDF 61 KB

    Purpose of report:

     

    To outline the response by Surrey County Council, NHS England Specialised Commissioning and Central and North West London NHS Foundation Trust to the recommendations made by the Sexual Health Services Task Group and agreed by the Health Integration and Commissioning Select Committee at its meeting on 4 July 2018.

     

    Additional documents:

    Minutes:

    Declarations of Interests:

     

    None

     

    Witnesses:

     

    Lisa Andrews, Senior Public Health Lead, Surrey County Council

    Dr Simon Edwards, Clinical Director, Central and North West London NHS Foundation Trust

    Ruth Hutchinson, Deputy Director of Public Health, Surrey County Council

    Fiona Mackison, Service Specialist, NHS England Specialised Commissioning

    Matthew Parris, Deputy CEO, Healthwatch Surrey

    Stephen Tucker, Deputy Service Director, Sexual Health and HIV, Central and North West London NHS Foundation Trust

    Key points raised during the discussion:

     

    1.     The Committee commended CNWL, NHSE Specialised Commissioning and Surrey County Council for their work in implementing recommendations  made by the Health Integration and Commissioning Select Committee.

     

    2.     Members were informed that the NHSE Specialised Commissioning South had put all of its staff through patient engagement training in response to the work of the Sexual Health Services Task Group and the recommendations made by the Select Committee.

     

     

    Actions/ further information to be provided:

     

    None

     

    RESOLVED:

     

    That the Health Integration and Commissioning Select Committee notes the  progress made by Central and North West London NHS Foundation Trust, NHS England Specialised Commissioning and Surrey County Council within the implementation of its recommendations.

     

20.

Recommendations Tracker and Forward Work Programme pdf icon PDF 57 KB

21.

Date of the Next Meeting