Agenda and minutes

To approve the record of the meeting held on 15 March 2011 and the record of the joint meeting of all Committees held on 25 May 2011.

The record of the meeting held on 15 March 2011 and of the Joint Meeting of all Committees held on 25 May 2011 were agreed and signed by the Chairman as correct.

A request was made for consideration to be given to future meetings of the Committee being moved to a later start time.  The Chairman undertook to look into this.

Apologies for absence were received from Councillors Maisey and Kearney and Christine Baker, Medway Pensioners’ Forum.

The Chairman will announce any late items which do not appear on the main agenda but which he/she has agreed should be considered by reason of special circumstances to be specified in the report. 

There were none. 

(a)               Personal interests under the Medway Code of Conduct.

A Councillor who declares a personal interest in a matter, including the nature of the interest, may stay, speak, and vote on the matter.

(b)               Prejudicial interests under the Medway Code of Conduct.

A Councillor who declares a personal and prejudicial interest in a matter, including the nature of the interest, must withdraw from the room and take no part in the debate or vote on the matter.

Councillors who have declared a personal and prejudicial interest may make representations, answer questions and give evidence before leaving the room but only if members of the public are allowed to attend for the same purpose.

If an interest is not declared at the outset of the meeting, it should be disclosed as soon as the interest becomes apparent.

(c)               Whipping – the Council’s constitution also requires any Member of the Committee who is subject to a party whip (ie agreeing to vote in line with the majority view of a private party group meeting) to declare the existence of the whip and the nature of it before the item is discussed.

Shirley Griffiths, LINk representative declared a personal interest by virtue of being a member of Medway NHS Foundation Trust and a member of South East Coast Ambulance Trust.

Councillor Murray declared a personal interest in any reference to Medway NHS Foundation Trust by virtue of her daughter’s employment at the Trust.

Councillor Watson declared a personal interest in any reference to the mental health trust by virtue of a family member receiving secondary mental health care in Medway. 

The Chief Executive of Medway NHS Foundation Trust will attend the meeting and update Members on the following:

(a)   a proposed merger of the trust with Dartford and Gravesham NHS Trust and

(b)   a recent breach of conditions imposed by MONITOR, the regulator for Foundation Trusts. 

Discussion:

The Chief Executive of Medway NHS Foundation Trust accompanied by the Chief Executive of Dartford and Gravesham NHS Trust gave an introduction to the proposed merger of the two trusts and responded to Members’ questions. 

Both Chief Executives highlighted that no decisions had been made at this stage but the feasibility of a merger was being actively explored.  They pointed out the potential benefits to a merger and discussed options for introducing areas of further specialisms in the hospital, which would mean that certain patients would be able to be treated in Medway for their condition, rather than having to be admitted to a London hospital.  This would also generate additional employment in the area.  Emphasis was placed on the fact there was no intention for either trust to close any core service, such as Accident and Emergency or Maternity Services, within either Darent Valley or Medway Maritime Hospitals.  As a point of clarification it was explained that as far as the merger of one Foundation Trust (Medway) with a non-Foundation Trust (Dartford and Gravesham) was concerned the merged organisation would be a Foundation Trust.

Responding to a question, the Chief Executive of Medway NHS Foundation Trust confirmed that redundancies were possible but that these would be administrative posts rather than in `customer-facing’ jobs.  He also stated that there would need to be independent due diligence applied as part of the feasibility study to ensure that proposed savings by a merger could be realised.

In response to questions the Chief Executive of Medway NHS Foundation Trust confirmed that only preliminary soundings had been taken on the proposals and once the feasibility study was complete he would be determining whether formal consultation was necessary.  He stated that the original development plans shared with Members for the hospital would not be going ahead on the basis of reduced budgets.  He also confirmed that account had been taken of proposed increases in populations in both areas.

He undertook to liaise with the Democratic Services Officer outside of the meeting about the date at which a further report would be brought to this Committee but the earliest date was likely to be 5 October 2011.

The Acting Chief Executive of NHS Medway responded to a question about Healthy Living Centres and said that NHS Medway would be looking carefully at estate used by the trust and accepted the need for investment in community services to reduce the demand for more expensive acute care.

The Chief Executive of Medway NHS Foundation Trust then advised Members of the position with regard to the trust’s response to the Monitor decision that the Trust was placed in breach of its conditions in relation to its failure to meet its overall financial plans in 2010/2011 incurring a deficit.

Responding to a query he stated that there would not be a negative impact on patients because of the financial position of the trust, in fact there were likely to be positive outcomes as processes became more streamlined and more  ...  view the full minutes text for item 116.

This item sets out a completed protocol questionnaire for substantial variations and developments in the health service, in relation to the proposed development of a trauma unit at Medway Maritime Hospital.

Discussion:

The Lead Director for the Kent and Medway Critical Care and Trauma Network introduced an item setting out proposals for dealing with major trauma incidents in Kent and Medway.  She and the Manager, Emergency Department, Medway NHS Foundation Trust responded to Members’ questions.

It was explained that the NHS Operating Plan for last year and this year identified trauma services as a priority and each region was expected to have Regional and local Major Trauma Networks and a strategy for delivery in place during 2010/2011 with trauma units being operational by 2012.

The Lead Director set out the parameters for a Major Trauma Centre and made clear that neither Kent nor Medway would have a great enough demand for such a centre.  It was being proposed that there would be three trauma units at Maidstone and Tunbridge Wells NHS Trust (Pembury site), East Kent Hospitals NHS Foundation Trust (William Harvey Hospital site) and Medway NHS Foundation Trust (Medway Maritime Hospital).

Members queried the adaptations that would be necessary at Medway Maritime Hospital and the Manager of the Emergency Department at the Hospital explained that minor modifications and the joining together of a number of staff rotas would be required.  Confirmation was given that the cost of any developments would be funded via payment by results.

Discussion took place about the need for appropriate rehabilitation facilities to be in place and for there to be rehabilitation for service personnel in need of assistance on returning to this country.  The Lead Director explained that specific armed forces arrangements were made in this instance.

The Director of Children and Adults supported the proposals put forward and emphasised the importance of critical, timely and indepth care being provided where multiple injuries had been sustained, not only for the patient but also supporting the carers and families involved.

Decision:

Members did not feel that the proposals constituted a substantial variation as far as Medway was concerned but noted that an invitation had been extended to the Committee to attend Kent’s Health Overview and Scrutiny Committee meeting to discuss trauma on 9 September 2011 at 10.00 a.m.

At the last meeting of the Committee Members requested an update on changes to the phlebotomy service to be brought to this meeting.  The report sets out the developments since 15 March 2011. 

Discussion:

The Acting Chief Executive, NHS Medway, accompanied by Dr Peter Green, Chairman of the emerging Clinical Commissioning Group for Medway and the Assistant Director, Communications from NHS Medway, introduced an update on phlebotomy.

It was stated that lessons had been learnt from the communications exercise accompanying the review on phlebotomy and these would be taken forward in future reviews. 

Responding to a question, Dr Green explained the measures taken to advertise the areas where blood could now be taken and stated that reception staff at GP surgeries had also been made aware of the changes.  He was unable to confirm the text now printed on the back of the request form for blood to be taken which had formerly detailed the available places where this could take place.  He undertook to look into this matter on behalf of the Committee.

With regard to a suggestion that commuters to London could have their blood taken there and the results transported back to Medway, he stated that this would require Medway to hold contracts with every phlebotomy clinic in London, which would be impossible and expensive to manage.  He did point out that a number of phlebotomy clinics in Medway close to railways stations had extended their opening hours and provided appointments, which would assist commuters by enabling them to attend an early appointment prior to travelling.

Discussion took place about the lack of phlebotomy clinics in the south of Strood compared to the north, which was a smaller area.  The Assistant Chief Executive, NHS Medway stated that people did not need to be registered at a GP practice to have their blood taken there so that should offer a greater choice for the public.

Confirmation was also given, in response to a question that glucose tests for diabetics are now done in the community.

Decision:

The Committee noted the update.

This report sets out the end of year performance against the Council Plan 2010-2011.

Discussion:

The Director of Children and Adults and the Assistant Director, Adult Social Care gave a brief introduction to the report on the end of year Council report and responded to Members’ questions.

Responding to a question about NI 146 adults with learning disabilities in employment the Assistant Director, Adult Social Care explained that across the year the figures would fluctuate considerably.  He also stated that it was only possible to include within the figures those people with learning disabilities who were eligible for services (those in the substantial or critical category) and in employment.  He emphasised the need for all employers across Medway giving consideration to employing people with learning disabilities and that it would be helpful for someone to champion their cause in Medway.

Some Members felt that more detail was needed in respect of the areas where the Council was performing below target to give the Committee a greater understanding and perspective on the impact on Medway residents to enable them to be clear about what was needed to improve the situation.  A request was made for a mid-term update on progress made.

The Director of Children and Adults undertook to review the above with the Assistant Director, Communication, Performance and Partnerships.

During debate the Director of Children and Adults informed the Committee that notice had been served on the Kent and Medway NHS and Social Care Partnership and that the service would be re-commissioned.  During the interim period she assured Members that the commissioner and the provider would work together to ensure the service was well managed and with integrity to protect the needs of service users.

Discussion took place about the Pathways to Inclusion programme, and the Director of Children and Adults and the Assistant Director, Adult Social Care acknowledged that this may have been a missed opportunity to benefit service users by both the council and the provider at the time the programme was on offer.

Decision:

The Committee noted the outcomes achieved against priorities and the request for more detailed information to be provided to the Committee as outlined above.

Members are asked to consider whether to add or remove items on the current work programme.

Discussion:

The Democratic Services Officer introduced the work programme and explained the arrangements set out in the report for the selection of a topic for a themed meeting or in-depth review.

With regard to the proposed item on Kings Road/Elm House moves it was stated that there may be a Member item submitted from Councillor Christine Godwin concerning the need to expand the services currently provided at Kings Road to extend to sexual health for older men and women.  The Assistant Chief Executive, NHS Medway confirmed that this would need to be dealt with separately to the item scheduled for 18 August 2011 and she undertook to discuss timings for this report with the Director of Public Health.

During discussion Members raised the consultation about an eating disorder review, which they had been notified about and stated that they would like to see the report once it is ready to be submitted.

The Democratic Services Officer reminded Members of the health and social care Member development event on 7 July 2011 to be held in room 1 at 6pm and the Chairman encouraged all Members to attend.

Decision:

The Committee agreed:

(a)                     that during June/July this Committee will draw up a list of potential topics for either an in-depth review or a themed meeting with a view to this list being considered at 18 August 2011 meeting and then referred to Business Support Overview and Scrutiny Committee on 20 September 2011 to be considered alongside other priorities;

(b)          to add the following items to the work programme for 18 August 2011:

·              Elm House/King’s Road moves

·              Kent and Medway Adult Safeguarding bi-annual report 2009/2010-2010/2011

·              Dementia

·              Topics for in-depth review/themed meeting (see (a) above)