Meeting documents

Adult, Community Services and Health Overview and Scrutiny Panel
Tuesday 9 November 2010

ADULT, COMMUNITY SERVICES AND HEALTH OVERVIEW & SCRUTINY PANEL

9 NOVEMBER 2010


PRESENT: Councillors Mrs Endacott (Chairman), Mrs Evans (Vice-Chairman), Baskerville, Mrs Kemp, Lenton, Majeed, Mrs Napier, Mrs Proctor and Mrs Yong.

Also Present: Mrs Finlay (Berkshire East Primary Care Trust); Ms Burgess and Mr Robinson (Heatherwood and Wexham Park Hospitals NHS Foundation Trust).

Officers: Mr Herlinger, Mr A Scott, Mrs Shawcross and Mr Skerman

part i


43/10 APOLOGIES FOR ABSENCE

None.

44/10 DECLARATIONS OF INTEREST

Councillor Mrs Proctor declared a Personal Interest in agenda item 5 – Discharge Arrangements: Heatherwood and Wexham Park Hospitals NHS Foundation Trust, agenda item 6 – Quality Of Care: Heatherwood and Wexham Park Hospitals NHS Foundation Trust and agenda item 7 – Heatherwood and Wexham Park Hospitals NHS Foundation Trust - Update On Financial Situation – as her husband was an outpatient at the Trust.

Councillor Mrs Napier declared a Personal Interest in agenda item 8 – Service Monitoring Report – as her son was in receipt of Direct Payments from the Council.

Councillor Mrs Kemp declared a Personal Interest in agenda item 4 – Urgent Care Centre, St Marks Hospital, Maidenhead – as a member of the Maidenhead Community Involvement Forum.

45/10 MINUTES
    RESOLVED: That the minutes of the meetings of the Panel held on 14 and 24 September 2010 be approved as a correct record.

46/10 URGENT CARE CENTRE, ST MARKS HOSPITAL, MAIDENHEAD

Members considered the report that had been submitted to the Berkshire East Primary Care Trust’s (PCT) Board held on 22 September 2010 on the review of the Urgent Care Centre (UCC) at St Mark’s Hospital, Maidenhead. This report provided an update on the development of the new service in its first four months of operation and outlined performance against key service objectives of access, cost and patient experience.
In response to a number of Questions, Mrs Finlay, Assistant Director Commissioning – Berkshire East Primary Care Trust, advised Members that 70% of patients were being seen with 30 minutes upon arrival at the UCC. She stated that the problems with the x-ray facility had now been resolved and that patient satisfaction levels with the service was high. She advised that staffing levels at peak times was being addressed in order to achieve the stated objective that 98% of patients were seen within 30 minutes. She also commented upon the attendance patterns of patients accessing the UCC and advised that the number of telephone enquiries was increasing, which was encouraging, as that enabled people to be directed to the appropriate facility.

Arising from the discussion, Members expressed their gratitude to the PCT for retaining the Urgent Care Centre at St Mark’s Hospital and were pleased that the facility was being well used and that patient satisfaction levels was high.

47/10 DISCHARGE ARRANGEMENTS - HEATHERWOOD AND WEXHAM PARK HOSPITALS NHS FOUNDATION TRUST

The Panel received a presentation from Ms Julie Burgess, Chief Executive – Heatherwood and Wexham Park Hospitals NHS Foundation Trust, on the Trust’s discharge procedures. Ms Burgess advised that the reduction in the length of stay and the better management of patient flow within the Hospitals were objectives within the Trust’s Turnaround Plan. Ms Burgess explained the ethos of Patient Centred Discharge Planning and commented upon the measures that were being introduced by the Trust and the changes being made to the admission and discharge processes to improve the process.

Ms Burgess commented that the Trust was working hard to address delayed discharge cases and referred to the multi-disciplinary approach that was now being adopted with other partner organisations and interested parties, such as the PCT, local authorities, Therapists and Pharmacists, to ensure that the discharge of patients was a smooth as possible. Members were advised that every person admitted to the hospital was now given an estimated discharge date, which was being monitored, and received details on the action being taken to address the discharge of patients with complex needs to ensure that everyone involved were aware of and fully understood the package of care needed for the patient.

Ms Burgess advised that a patient centred care holistic assessment and a well planned discharge not only reassured the patient and their family but also improved the quality of life and optimal independence back in their place of discharge. Ms Burgess advised that an update report would be provided to the Panel in 6 months to provide feedback on the effectiveness of the new arrangements.

In response to a number of questions, Ms Burgess commented upon how the Trust was dealing with the discharge of patients where their discharge date could not be predicted and referred to the need to educate some doctors to plan better for the discharge of patients. The need for a consistent approach to be adopted throughout the Trust was stressed. Ms Burgess also commented upon changes being introduced to the IT systems that would allow for more discharge details to be sent electronically.
Ms Burgess commented that the Trust was looking at the current processes and systems in order to address the issue of delayed transfers. Mrs Shawcross, Director of Adult and Community Services, advised that the Council was working with the Trust to improve patient care pathways and advised that a report would be presented to the January 2011 meeting of the Panel on the improvements to the Re-ablement Service.

48/10 QUALITY OF CARE - HEATHERWOOD AND WEXHAM PARK HOSPITALS NHS FOUNDATION TRUST

The Panel received a presentation from Ms Julie Burgess, Chief Executive – Heatherwood and Wexham Park Hospitals NHS Foundation Trust, on the Trust’s quality agenda. Ms Burgess commented upon the Trust’s Quality aims, which were to deliver safe, clinically led, high quality care for patients and to provide a safe and positive patient experience and referred to the campaigns, initiatives and work streams being carried out by the Trust to achieve those aims.

Ms Burgess commented upon the production of Quality Accounts, which all Trust’s were required to publish annually, and advised that they would be made publicly available. She referred to the reports that were regularly submitted to the Trust’s Board on patient safety and patient feedback and how the Trust monitored trends and dealt with concerns raised in those reports to ensure that it operated in line with best practice.

In response to a number of questions, Ms Burgess commented further on the role of the Patients’ Champions and confirmed that they did request feedback from patients and carers on the issue of dignity. She also advised that the Trust’s IT systems were being upgraded to ensure that they were better integrated and referred to the recruitment and retention initiatives being carried out to ensure that the Trust remained attractive to employees and prospective employees, particular in relation to those Trusts nearby that were able to pay a London weighting.

Arising from the discussion, it was agreed that the Trusts’ Quality Account be presented to the Panel in 6/8 months.

49/10 HEATHERWOOD AND WEXHAM PARK HOSPITALS NHS FOUNDATION TRUST - UPDATE ON FINANCIAL SITUATION

The Panel received an update on Heatherwood and Wexham Park Hospitals NHS Foundation Trust’s current financial position and progress on key activities within the Trust’s Turnaround Plan. Mr Robinson, Director of Finance – Heatherwood and Wexham Park Hospitals NHS Foundation Trust, advised that the Trust had been successful in securing £18M of transitional financial support from the Department of Health and that the Trust’s Turnaround Plan would be refreshed to reflect that additional funding. He commented upon the higher than anticipated activity experienced in the first part of the financial year and advised that the overspend of £5M had been offset by a reduction in non-clinical activity.

Ms Burgess and Mr Robinson then responded to a number of comments/questions raised by Members of the Panel. Members were advised that the increase in activity had been in non-elective services, which other Trusts’ were also experiencing, and informed Members that the Berkshire East Primary Care Trust had put measures in place to address the issue. He stressed that the Trust were looking at reducing the Trust’s overall spend without affecting the delivery of clinical services. Ms Burgess commented upon the work streams that had been set up to address the quality of the Trust’s data and stated that the Trust had worked closely with the Unions on the development of its Travel Plans, advised that, although their implementation had been delayed, it was recognised that it would take some time for employees get used to the new arrangements.

50/12 SERVICE MONITORING REPORT

The Panel received and commented upon the latest service monitoring report for activity within the Adult, Community and Health Services during the second quarter of the current financial year. The report also outlined the key achievements in the last quarter, the achievements expected in the next quarter, expected future pressure concerns and performance trends.

Arising from the discussion, the Officers responded to a number of comments/questions raised. In particular, the officers referred to the decision taken by Cabinet in July 2010 to ceases to provide a direct homecare service by 31 March 2011 and outlined the procurement process that would be seeking to secure the provision of a diverse range of replacement services from external providers. Mr Skerman outlined the additional services that could be provided by external providers to support service users, referred to the proposed contractual conditions and existing regulatory framework to regulate and monitor service providers and advised that a training programme would be available to ensure that providers were able to meet and adhere to the required standards.

Members were advised that the Government’s target for use of B&B for family households was zero, which had been consistently met by the Royal Borough. However, it was stressed that the calculation was based on moving a family out of B&B within a 6-week period. As a result, it did not mean that the Council did not use B&B at all. Families were often provided with B&B whilst their case was being investigated but the family would be moved into other temporary accommodation until permanent housing was found. If a family was found to be intentionally homeless the B&B arrangement could be terminated very quickly, which could not be done for other types of housing. As a result, the Council reported zero use of B&B for the Government's National Indicator, but had other local performance information on actual use of B&B, which was still quite minimal.

In response to a comment on the development of preventative services, Members were advised that details would be presented in the report on the Re-ablement Service at the January meeting of the Panel. With regard to the development of advice for “wealth depleters”, Members were informed of the need for the Council to ensure that people made the correct choice and received the right advice.

Members were also advised that, in the light of the changes to the proposed directorate structure, work was progressing to ensure the structure was correct and that any mismatch in skills within teams was satisfactorily addressed. A report would be submitted to the Employment Panel in due course.

51/10 WORK PROGRAMME

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

52/10 MEETING

The meeting, which began at 7.30pm, ended at 9.30pm.