Agenda and minutes

            The Minutes of the meetings held 8^th and 28^th March 2011 having been printed and circulated were signed as a correct record.

            The Board was advised that no public questions had been received.

            The Board considered the Minutes of the meetings of the Executive Board Sub Committee relevant to the Health Policy and Performance Board.

 

            RESOLVED: That the minutes be noted.

The Minutes of the Health Strategic Partnership Board of its meeting held on 10 March 2011 were submitted to the Board for consideration

 

           RESOLVED: That the minutes be noted.

The Board considered a report of the Strategic Director, Policy and Resources regarding the 4^th Quarter Monitoring Report for:

 

·              Prevention and Commissioning Services;

·              Complex Needs; and

·              Enablement Services.

 

The following comments arose from the discussion:-

 

·        PCSI 1 – Repossession – Due to budgetary cuts to the Citizen Advice Bureau and in the economic climate it was suggested that the Board would need to monitor this situation as more houses could be re-possessed in the Borough.  It was noted that the Authority had a mortgage advisor who could help with this situation;

 

·        PCS10 – It was noted that the Authority undertook the training of staff employed by the independent sector registered care services on the protection of adults;

 

·        Page 60 -% of items of equipment and adaptations delivered within 7 working days - the Board took the opportunity to place on record their congratulations to Officers on their excellent performance;

 

·        NI236 – Early access for women to maternity services - It was agreed the Recovery Plan be monitored by the Board, 

 

·         It was noted that questions had been submitted prior to the meeting and a response provided which had been circulated at the meeting and would be attached as Appendix 1 to the minutes

 

RESOLVED: That the report and comments made be noted.

The Board considered a report of the Strategic Director, Communities which presented the Annual Report for the Health Policy and Performance Board for April 2010- March 2011 attached as Appendix 1 to this report.

 

It was reported that during 2010 -11 the Board had looked in detail at many of Halton’s Health and Social care priorities. Further details of these were outlined within the Annual Report set out in Appendix 1 to the report.

 

RESOLVED: That the report be noted.

Note: (Councillor M Lloyd Jones declared a Personal Interest in the following items of business due to her husband being a Non Executive Director of Halton & St Helens Primary Care Trust.)

 

The Board considered a report of the Strategic Director, Communities which gave Members an update on the recent Patient and Public consultation regarding the potential closure of the nurse led Windmill Hill Access Centre.

 

The Board was advised that a report had previously been submitted to Halton & St Helens PCT Clinical Commissioning Committee in October 2010 and to the Finance Performance Approvals Committee on 27^th April 2011.

 

The Board was further advised that prior to 1997 the residents of Windmill Hill had access to a singled

handed GP practice for their health needs. However, when the GP had left, the existing patient list had been distributed between Castlefields and Murdishaw practices.

 

Ms Chris Turner, Halton & St Helens PCT and Ms Elaine McDowell, Bridgewater, Halton and St Helens division were in attendance at the meeting to present the report.  They reported that the Windmill Access Centre had been introduced and provided a limited service to the residents of Windmill Hill. This service, which is delivered by Bridgewater Community Health Services staff, is open from 9am until 5pm Monday to Friday (excluding Bank Holidays) and people access the service by telephoning for an appointment time.  However, if they arrived without an appointment they could wait to be seen by a nurse.

 

Since opening, the access centre had provided health care for people who had coughs, sore throats, rashes, and many other minor illnesses. However, people who had more complex or long term conditions required the continuity provided by their own GP.

 

On the 29th January 2010 the new Equitable Access GP practice had been opened to the residents of Windmill Hill, and now had a list size of 1173 patients. The new GP practice provided an enhanced service to that available

at Windmill Hill Access Centre. For example: Women’s Health Clinic, Well Woman Clinic, Well Man Clinic, Mother & Baby Clinic,Travel Health, Smoking Cessation, Phlebotomy, Respiratory Clinic and many more.  There had also been an increase in the opening hours and the facility was available  seven days a week.

 

In January 2011 the PCT  had completed a three month consultation with the residents of Windmill Hill regarding the access centre.  The results from the consultation highlighted the need for access to health care. It was proposed to close the nurse led access centre from 1 August 2011.

 

The following comments arose from the discussion:-

 

·     The Members noted that the Member for the Windmill Hill ward was not in attendance at the meeting;

 

·        It was noted that there would be no job losses as a result of the changes;

 

·        Clarity was sought on how the changes would be communicated to the community.  In response, it was reported that the Primary Care Trust would be developing a full communication plan to ensure the community were aware of the changes.  In addition, patients had already been registered at Murdishaw and Castlefield surgeries; and

 

·        It was noted that the new GP centre was fully accessible for people with disabilities.

 

RESOLVED: That

 

(1)          the report  ...  view the full minutes text for item 7.

The Board considered a report of the Strategic Director, Communities which gave Members a summary of the Quality Accounts 2010/11 for Warrington and Halton NHS Foundation Trust.

 

The Board was advised the Quality Accounts summary detailed a comparison between 2009/10 figures and 2010/11 figures for various subject areas, for example, infection control, pressure ulcers, Thromboprophylaxis, falls, Hospital Standardised Mortality Review (HSMR), along with a narrative for each area.

 

Mr David Melia, Director of Nursing, Warrington and St Helens NHS Foundation Trust attended the meeting to present the report,  Mr Melia outlined the issues and priorities that had been identified last year for improvement and provided assurance on performance in respect of:-

 

• Infection Control;
• Hospital acquired pressure ulcers;
• Falls;
• The Hospital Standardised Mortality Review;
• The significant improvement in reducing the number of cardiac arrests in hospital;
• Complaints;
• The PALS Service; and
• The National In Patient Survey 2010.

 

The following comments arose from the discussion:-

 

·        Clarity was sought on the procedures that were in place for when a patient used their call bell, In response, it was reported that one of the priorities for the organisation was to look at ways of freeing up nurse time to enable them to have more control of their wards, spend more time with patients and relatives and undertake regular ward rounds.  This would result in nurses being more aware of any issues/concerns that a patient may have and reduce the need for that patient to use a call bell.  It was noted that this would present a challenge.  However, it was also noted that work was being undertaken with staff to identify areas of duplication, work processes and what activities take nurses away from providing clinical care;

 

·        It was noted that a recent unannounced inspection had shown that staff were very responsive to the needs of the patient and the dignity in care for older people had received an endorsement;

 

·        It was noted that there had been some improvement in electronic systems such as the transfer of images between the sites, but as yet electronic records had not been developed;

 

·        Clarity was sought on whether there were any action plans for the eight target areas.  In response, it was reported that each area was project led, with clear aims and objectives and a monitoring process in place.  It was suggested that this information could be presented to a future meeting of the Board;

 

·        Clarity was sought on the information relating to falls – out of the 55 patients, how did they fall, where they alone when they fell and the age range.  In response, it was reported that the detailed information was available on the website.  Members requested the link to the website and it was agreed that this would be circulated to all Members of the Board;

 

·        Clarity was sought on MRSA procedures in relation to informing family members or carers when the patient was discharged from hospital, In response, it was reported that this raised issues of confidentiality and the  ...  view the full minutes text for item 8.

The Board considered a report of the Strategic Director, Communities which introduce the draft report of the Scrutiny Review of Dignity in Care. 

 

It was reported that Appendix 1 set out in the report was commissioned by the Board.  A scrutiny review working group had been established with five Members from the Board, a Principal Policy Officer from the policy team, the Dignity in Care Co-ordinator and the Divisional Manager from the Independent Living Service.

 

The Board was advised that the report had been commissioned as Halton Borough Council was the only local authority in the country with a Dignity in Care Co-ordinator, as well as the only one that covered both the council and the wider remit of Health. 

 

The scrutiny review had been conducted through a number of means between October 2010 and April 2011, as follows:

 

·        Monthly meetings of the scrutiny review topic group;

 

·        Presentations by various key members of staff from the Council and Health (detail of the presentations were attached at Appendix 2 of the report);

 

·        The provision of information;

 

·        Service-user consultation; and

 

·        A field visit to a Productive Ward at Whiston Hospital.

 

An additional paper was circulated at the meeting which requested that Members endorse the report and all the recommendations that were in their report.  In addition it be agreed that they should be put together at the end of the report for clarity. The Board was advised that the report would be presented to the Executive Board for approval. In addition, it was  agreed that the Board monitor progress on the recommendations on a six monthly basis.

 

RESOLVED: That

 

(1)                     the comments raised be noted; and

 

(2)                     the Dignity in Care Scrutiny Review endorse the following recommendations:-

 

·        to include the Multi Agency contact sheet in a future edition of Inside Halton;

 

·        endorse continued briefing and training of staff both within social care and health and continue with the public awareness raising;

·        continue to positively promote the work of personalisation within Halton;

 

·        the group suggest the continued roll out of the Productive Ward concept in both Warrington and Whiston hospitals;

 

·        the use of Health Passports throughout the care system and extended beyond adults with learning disabilities;

 

·        in single sex wards in Whiston Hosptial the male/female sign on toilets should also be accessible to people with visual impairment; and

 

·        Whiston Hospital to implement training/guidance for staff to feel comfortable raising concerns / making complaints;

 

(3)                     the recommendations be presented to the Executive Board for adoption; and

 

(4)          the Board receive six monthly update reports on the progress of the recommendations.

The Board considered a report of the Strategic Director, Communities which presented the process undertaken for the production of the 2011 Joint Strategic Needs Assessment (JSNA).

 

          The Board was advised that the draft executive summary was attached in Appendix 2 to the report which included a summary of key findings and priorities.

 

          The following comments arose from the discussion:-

 

·              It was noted that a question had been submitted prior to the meeting and a response provided which had been circulated at the meeting and attached as Appendix 1 to the minutes

 

·              It was agreed that as there was an overlap with the Children and Young People’s Policy and Performance Board, that the report sent to Members of that Board;

 

·              It was agreed that contact details of the Mortgage Rescue Advisor would be circulated to all Members of the Board;

 

·              Concern was raised that due to the budgetary cuts elderly people could be more vulnerable to falls in the evening.  In response, it was reported that Telecare was available and there had been an increase in the health budget for night services on a temporary basis and this gave the Authority an opportunity to try out new approaches; and

 

·              It was noted that it was a very good comprehensive report.  However, it was suggested that in light of the current economic downturn, future reports contain information on the work available in the Borough as this impacted on the health and well being of families.

 

RESOLVED: That the report and comments raised be noted.

The Board considered a report of the Strategic Director, Communities which provided information on the progress in achieving targets contained within the Sustainable Community Strategy for Halton.

 

The Board was advised that the Sustainable Community Strategy for Halton, and the performance measures and targets contained within it would remain central to the delivery of community outcomes. It was therefore important that progress was monitored and that Members were satisfied that adequate plans were in place to ensure that the Council and its partners achieved the improvement targets that had been agreed.

 

The following comments arose from the discussion:-

 

·        In respect of NI 142 – Improve the number of vulnerable people supported to maintain independent living – Clarity was sought on how many services were commissioned.  Members also requested more information on the service;

 

·        It was agreed that information on the Floating Support Service would be circulated to all Members of the Board;

 

·        It was noted that organisations were encouraged to submit their performance monitoring data.  It was also noted that sometimes organisations had failed to submit their data due to the timescales; and

 

·        It was suggested that a list be provided of performance indicators that had ceased to exist at the national level be produced with an indication of how they would be monitored in the future,  In response, it was reported that the next steps would be to identify priorities in order to determine what the performance indicators would need to be,  This process had just commenced and Members views were welcomed.

 

RESOLVED: That the report and comments raised be noted.

The Board considered a report of the Strategic Director, Communities which reported that NHS Halton and St Helens were undertaking a formal consultation on future plans for the building known as The Cheshire and Merseyside Treatment Centre.  This report was being presented to gain views from the Health Policy & Performance Board as part of this consultation.

 

The Board was advised that the Cheshire and Merseyside NHS Treatment Centre (CMTC) was located adjacent to Halton Hospital in Runcorn. The CMTC had been operational since 2006 providing a range of Orthopaedic services, to residents of Halton in addition to residents from Cheshire and Merseyside. The CMTC was had ceased the provision of the current Orthopaedic services on the 31^st May 2011.

 

The Board was further advised that NHS Halton and St Helens had developed a business case which identified a range of options to be considered for the future provision of services on this site.  Four broad options had been identified by the PCT and Runcorn GP Commissioning Consortium as from 1^st June 2011 as follows:-

 

·        Do nothing- included only to provide a benchmark for cost comparison;

·        Divest- sell the building on the open market guided by an assessment by the District Valuer;

·        Lease- seek through a procurement process an organisation that was willing to take on a lease for the building; and

·     Utilisation- use the asset for local health care provision, if costs including capital charges, depreciation and running costs could be recouped.

 

It was reported that NHS Halton and St Helens would be consulting with all key local stakeholders in relation to these proposed plans.  The consultation period ran from 6^th May 2011 to 29^th July 2011.

 

The report, concluded that taking into account the overall mix of benefits, costs and risks and assuming that the covenant did not apply, it was recommended that further work be undertaken to develop the implementation option details for D2 and D3 set out in the report.

 

The Board also received a presentation from Mr Simon Bank, Halton and St Helens Primary Care Trust (PCT), outlining the key issues and benefits within each option.  He also reported that various public events had been arranged in Widnes, Runcorn and St Helens to obtain views from the public.  The PCT had also met with MP’s across Cheshire and Merseyside and would be presenting the report to the Executive Board and Area Forums to enable an open consultation.  The decision would be made in September 2011 and the preferred option progressed fairly quickly.

 

The following comments arose from the discussion:-

 

·        Clarity was sought on whether the option put forward could be delivered, particularly in light of the Government proposed change..  In response, it was reported that the options had been through the process of a benefits evaluation and had been led by the GP Consortia.  The proposed options would deliver the best patient experience and the long term needs of patients in Halton;

 

·        Clarity was sought on whether this would have an  ...  view the full minutes text for item 12.

The Board considered a report of the Strategic Director, Communities which gave Members an update on the development of a Shadow Health and Well-being Board for Halton, Halton’s application to become an Early Implementer of Health and Well-being Boards and detailed the draft terms of reference for comment and discussion.

 

The Board was advised that it was proposed that a Shadow Health and Well-being Board would be established by summer 2011. Recent consultation with GP colleagues highlighted a desire not to rush into any formal arrangements, but to take a more measured approach in order to allow the new Board to evolve as all parties became clearer about their respective roles and the emerging role for the new partnership Board. In order to progress development of a Shadow Board the following points were suggested for action:

 

·        Distribute the Draft Terms of Reference more widely following comments from PPB members;

 

·              If it is agreed that the new Shadow Health and Well-being Board could also incorporate the role of the Health Partnership Board and arrangements would need to be made to dissolve the HHP Board;

 

·              Arrange the first meeting/ development session for the new Shadow Health and Well-being Board to take place in Summer 2011; and

 

·              Make use of the Early Implementer Network to share experiences with other areas and benefit from the expertise offered from the DH.

 

The following comments arose from the discussion:-

 

·              It was noted that two questions had been submitted prior to the meeting and a response provided which had been circulated at the meeting and attached as Appendix 1 to the minutes;

 

·              In respect of Page 282, paragraph 3.15 of the report -– it was noted that this would significantly increase the workload and the responsibilities of Elected Members with less resources from Officers of the Council.  It was also noted that the Board would need further reports in order to monitor the situation; and

 

·              It was agreed that the Board receive the minutes of the Heath and Well Being Board as a standard item on the agenda.

 

RESOLVED: That

 

(1)                     the content of the report and comments raised be noted;

 

(2)                     the draft Terms of Reference set out in Appendix 1 to the report be supported;

 

(3)                     the recommendations for the links to the Health and Well Being Boards for Children’s Services as set out in paragraph 3.19 of the report be supported;

 

(4)                     the next steps as set out in paragraph 3.30 of the report be agreed; and

 

(5)                     the Board receive the minutes of the Health & Well Being Board as a standing item on the agenda.

The Board was reminded that Standing Order 51 of the councils constitution stated that meetings should not continue beyond 9 pm

 

RESOLVED; That Standing Order 51 be waived to allow the meeting continue beyond 9 pm

The Board considered a report of the Strategic Director, Communities which gave Members an update on key issues and progression of the agenda for Safeguarding Vulnerable Adults.

 

The Board was advised that Halton LINk had held an informal ‘drop-in’ event/coffee morning in February 2011 to mark Dignity Action Day.  The aims were to offer LINk’s support to the local and national Dignity in Care campaign, to raise awareness of the importance of Dignity in Care and highlight what was taking place locally, remind society that the dignity of those in their community was not the sole responsibility of health or social care staff- and that everyone had a role to play, remind the public that staff have a right to be treated with dignity and respect too, and  hear about people's experiences of local health and social care services over the past 12 months.

                                                  

The Board was further advised that on the 15th February 2011, a shocking report from the Health Service Ombudsman, Ann Abraham, had been published called “Care and Compassion” www.ombudsman.org.uk.

 

The Board noted the key issues and progressions of the safeguarding agenda set out in paragraphs 3.3 – 3.10 of the report

 

The following comments arose from the discussion:-

 

·        It was noted that the definition of ‘Serious Untoward Incident’ would be circulated to Members of the Board;

 

·        Clarity was sought on the change in respect of CRB checks.  In response, it was reported that the list of occupations within the CRB check system was comprehensive, with different levels of checks required depending on the occupation i.e. basic, standard and enhanced.  However, it had been proposed that this list be extended to incorporate additional occupations at various levels and this had been put on hold;

 

·        Concern was raised that some agency staff could be operating in the community without a CRB check.  In addition, clarity was sought on whether Members could undertake visits to residential/nursing homes in the Borough as part of the safeguarding duties.  In response, it was reported that some Members do undertake visits to residential/nursing homes, but it would be via an appointment and as they were now independent providers, it was not an automatic right.  However, the Contract Team, who were responsible for the contracts with external providers of care services undertook regular visits of the establishments and also had various methods of collecting data and focussing on any concerns that are raised.  In addition, it was agreed that a previous report which had been considered last year highlighting a sample of the quality of services that were provided for Halton be circulated to all Members of the Board for information.

 

RESOLVED: That report and comments raised be noted.