PRESENT: Councillors Meadowcroft (Chairman), Mrs Endacott (Vice Chairman), Baskerville, Mrs Evans, Mrs Kemp (substituting for Councillor Majeed), Lenton, Mrs Proctor and Mrs Yong.

Non Members: Councillor Dudley

Also Present: Mr M Ainsworth (South Central Ambulance Service); Mrs H Blanchard, Mr J Jones & Mrs K Proctor (Heatherwood & Wexham Park Hospitals NHS Foundation Trust) Mrs C Finlay and Mr T Keable (Berkshire East PCT), Mr A Kennedy and Mr P Rowley (Berkshire Shared Services) and Mrs S Holmes (Windsor, Ascot and Maidenhead LINk)

Officers: Mr Abrahamson, Mr Allan Brown, Mrs Gallagher, Mr Herlinger, Mrs Kerfoot, Mrs Patterson, Mr Richardson, Mr Scaife, Mr A Scott, Mr Taylor and Mr Thompson.

8/09 APOLOGIES FOR ABSENCE

Apologies for absence were received from Councillors Majeed and Mrs Napier.

9/09 DECLARATIONS OF INTEREST

None

10/09 MINUTES

RESOLVED: That the Part I minutes of the meetings of the Panel held on 5 May and 24 June be approved.

11/09 AMBULANCE RESPONSE TIMES

The Panel were reminded that as from 1st April 2009 Heatherwood Hospital had ceased to accept some 999 calls, which they would have previously accepted, and no longer accepted patients with chest pains or patients suffering from Cardiac Arrests along with other more serious conditions. In addition, GP admissions would also cease from 1st August 2009.

Mark Ainsworth, Divisional Director Berkshire for South Central Ambulance Service (SCAS), advised that SCAS had worked closely with Heatherwood and Wexham Park Hospitals NHS Foundation Trust to assess the impact of the changes to medical emergency admissions. He provided a detailed breakdown of journey times to hospitals for emergency patients from various parts of the Borough and the surrounding areas. The analysis had concluded that, assuming the majority of patients that were previously conveyed to Heatherwood were now being conveyed to Wexham, SCAS patients would be admitted on average 2 minutes quicker.Mr Ainsworth stressed that the medical emergency admission changes at Heatherwood would not affect SCAS response to patients calling 999 as resources, both Ambulances and Rapid Response Cars, would continue to be placed in areas to maximise cover across East Berkshire. The 999 calls would always be taken to the nearest A&E department unless specified by an admitting Doctor to be conveyed to another location.

In response to a number of questions, Mr Ainsworth advised that both Frimley Park Foundation Trust and Royal Berkshire Hospital Foundation Trust had been advised of the changes and had not raised any concerns to the fact that some additional patients would be transferred to their hospitals. In response to concerns raised about capacity within the ambulance service in the light of the changes, Mr Ainsworth stated that there had been a 30% increase in general activity compared to the previous year and, although mindful of budgetary constraints, commented upon the need to build resources to meet future demand. He commented upon journey times from the Ascot area to Wexham Park Hospital and confirmed that there had been no detrimental impact arising from the changes.

12/09 MINOR INJURIES UNIT – ST MARKS HOSPITAL

The Panel received an update on the number of patients using the Minor Injuries Unit (MIU) at St Mark’s Hospital, Maidenhead. It was noted that the number of people using the MIU continued to rise and that an average of 44 patients a day were currently being dealt with at the MIU. It was noted that the MIU continued to operate reduced hours due to recruitment difficulties and that the results of the patients survey would be issued in late August.

In response to a number of comments/questions, Members received an explanation for the increase in a number of the referrals to the MIU. The continued difficulties in the recruitment of specialist staff, which was a national problem, was highlighted and Members were advised that Heatherwood and Wexham Park Hospital NHS Foundation Trust was currently running a training programme to increase the pool or resources available in order to address that problem. The Trust confirmed that they would look into the concerns raised about people being re-directed elsewhere when attending the MIU and confirmed that improvements to the reception area and enhancements to the Unit would be undertaken if the facility became permanent. It was noted that the PCT Board would consider the results of the pilot future of the MIU at its September meeting.

Arising from the discussion, the PCT confirmed that it was keen to commission the service long term and, although current activity levels indicated that the Unit appeared viable, it was stressed that an assessment had to be made of what was being provided to ensure that they met the expectations of the PCT. Members reiterated their concerns about the inability to recruit staff to the MIU to ensure that the Unit was fully operational and the need to for improvements to be made to the facility, in particular the reception area. Although more people continued to access the Unit, Members were anxious that more people used the service in order to reduce the cost per patient.


13/09 CAR PARK CHARGES AT ST MARK’S AND KING EDWARD VII HOSPITALS

Members received an update on the effect of the introduction of car park charges at St Mark’s and King Edward VII Hospitals. Members were advised that the charges, which had been implemented on a phased basis, had been introduced with little fuss and the concerns expressed about the displacement of vehicles onto the adjoining roads, particularly around St Mark’s Hospital, had not materialised. A breakdown was given of the cost of administering the scheme and income levels. Members also received details of the implementation of a new staff parking scheme that was designed to create more spaces for patients at both locations, particularly at peak times.

Arising from the discussion, the PCT were asked to confirm that there was no cross subsidy from car parking to other non car park related services, which they indicated would be given as part of the next progress report to the Panel. The PCT had worked closely the Councils’ Highways Section but Members were advised that, due to the longer that envisaged consultation with residents on the introduction of the yellow lines and short stay parking bays around St Mark’s Hospital, the decision had been taken to introduce the parking charges prior to the introduction of those highway measures. However, it was confirmed that those highway measures were to be installed imminently.

14/09 “SAVING MORE LIVES” – CONSULTATION BY HEATHERWOOD AND WEXHAM PARK HOSPITALS NHS FOUNDATION TRUST

Members received details of Heatherwood and Wexham Park Hospitals NHS Foundation Trust’s consultation on the service changes the Trust were planning to make at Heatherwood and Wexham Park Hospitals, which had been highlighted and discussed at the previous meeting of the Panel. The Lead Member for Adult and Community Services indicated that he had written to the Trust to express his strong support for Heatherwood Hospital. The Panel also expressed the strong view that Heatherwood Hospital was an essential facility providing important health services to local residents and should be retained and enhanced.

RESOLVED UNANIMOUSLY: That the Trust be advised that the Panel were unanimous it its strong support for each of the proposals to develop services at Heatherwood Hospital.

15/09 SAFEGUARDING ADULTS WITH LEARNING DISABILITIES

The Panel considered a report that provided details of local actions that were required in response to issues raised in the Local Government Ombudsman report on Six Lives: the provision of public services to people with learning disabilities, and the Commission for Social Care Inspection (CSCI), Healthcare Commission and Mental Health Act Commission national report of joint review on Commissioning services and support for people with learning disabilities and complex needs.

The Panel also received a presentation from Mrs Louise Kerfoot, Service Manager, Learning Disability Services, who commented upon the findings of the report. She advised that the reports had concluded that commissioning was inadequate to meet the needs and aspirations of people with complex needs, planning and leadership was weak and that generally Health staff lacked understanding of needs of people with complex needs. She advised that the reports had highlighted problems arising from poor communication, poor co-ordination between relevant services, the failure to follow routine procedures, the quality of management and advocacy. It was noted that all NHS bodies and social care organisations were required to review the effectiveness of the systems in place to enable them to understand and plan to meet the full range of needs of people with learning disabilities in their areas, and the capacity and capability of the services they provide and/or commission for their local populations to meet the additional and often complex needs of people with learning disabilities. Mrs Kerfoot also commented upon actions that had already been implemented in the light of the reports’ findings.

She advised that the NHS bodies and social care organisations were required to report back by March 2010 to their respective Boards, and that a progress report would be submitted to the Panel in January 2010.

Arising from the discussion, although it was considered necessary to have all the appropriate policies and procedures in place, the need to ensure that they were implemented and monitored effectively was stressed. Members discussed the greater use of Communication Boards and the role of the Learning Disability Liaison Nurse, which would co-ordinate care for people accessing acute services. The need to look at the dignity agenda around secondary care was highlighted. Members also commented upon the proposed consultation with service users and it was suggested that consideration should be given to carrying out in depth interviews with a cross section of service users as that should provide better feedback than a more general consultation with all service users.

RESOLVED UNANIMOUSLY: That a progress report be submitted to the Panel at its meeting in January 2010.

16/09 PERSONALISATION WITHIN ADULT SOCIAL CARE

Members considered that draft contribution policy and guidance that had been produced detailing how people with an assessed need for Social care would be charged for non-residential care services, and which had been considered by Cabinet on 25 June 2009. It was noted that the draft policy would go out to consultation in the Summer, with a report back to Cabinet on the results of that consultation in October 2009.

Arising from the discussion, the Officers responded to a number of question/concerns on the draft policy. In particular, in response to concerns expressed about the effect the new arrangements would have on those people currently in receipt of highly subsidised services, Members were advised that the new arrangements were more equitable, although it was acknowledged that there would some that would be better off and some worse off. However, it was pointed out that those people who currently enjoyed a high level of services may chose not to buy the same level of services in the future or may prefer to consume the services in a different way. Members were advised that there would be sufficient flexibility in the system to allow for the completion of the financial assessments and that the two week deadline would not be strictly adhered to. It was noted that the definition of couples was that used in common law and which was currently used by the Council. With regard to disability related benefits, Members were advised that the report would be amended in order that care allowances were taken into account.

It was agreed that a report would be submitted to the Panel in the Autumn following the consultation period. It was also agreed that a progress report be submitted to the Panel monitoring the introduction of the Pilot scheme 9 months after its implementation.

17/09 SERVICE MONITORING REPORT

The Panel received and noted the latest service monitoring report for activity within the Adult, Community and Health Services during the period to 31 May 2009. It was noted that the Adult Social Care budget showed an under spend of £274k, which related mainly to a reduction in inflation rates on care contracts and the impact of demographic changes.

18/09 MOBILE LIBRARY CONSULTATIONThe Panel noted the results of the consultation that had been undertaken to determine the degree of acceptance among users to changes to the Mobile Library Service. It was noted that there had been broad acceptance to the proposal to revise and merge the routes from the Homes library service with the Public library service and the adoption of a 3-week schedule of visits.

19/09 WORK PROGRAMME

Members noted the items that had been identified for submission to the next meeting.

20/09 LOCAL GOVERNMENT ACT 1972 – EXCLUSION OF THE PUBLIC

RESOLVED: That under Section 100(A)(4) of the Local Government Act 1972, the public be excluded from the remainder of the meeting whilst discussion takes place on items 13 and 14 on the grounds that they involve the likely disclosure of exempt information as defined in Paragraphs 2 and 3 of part I of Schedule 12A of the Act.