Agenda and minutes

To approve the record of the meeting held on 6 October 2011.

The record of the meeting held on 6 October 2011 was agreed and signed by the Chairman as correct. 

Apologies for absence were received from Councillors Griffin and Rodberg and Christine Baker.  The Chairman announced that Christine Baker was in hospital following a fall.  The Committee wished for their good wishes to be sent to Christine Baker to wish her a speedy recovery.

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. 

The Chairman announced that the late report on adult mental health social care needed to be dealt with as an urgent item for the reasons stated in the report.

(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 declared a personal interest as she is a member of the Medway NHS Foundation Trust and the South East Coast Ambulance Trust.

Councillor Igwe declared a personal interest as he is a mental health practitioner working for the prison service and the NHS.

Councillor Kearney declared a personal interest as she is a Member of the Medway NHS Foundation Trust and also the South East Coast Ambulance Trust.

During debate later in the meeting Councillor Purdy declared a personal interest in Age Concern as she is a trustee of that organisation and Councillor Christine Godwin declared a personal interest in Medway Older People’s Partnership as she chairs the Partnership.

This Member item has been submitted by Councillor Shaw to scrutinise issues raised by the publicity of the mortality figures at Medway Maritime Hospital. 

 Discussion:

Councillor Shaw gave a brief introduction to a Member item she had requested in relation to the publicity of the mortality figures at Medway Maritime Hospital. 

Dr Smith-Laing, Medical Director at Medway Maritime Hospital gave a powerpoint presentation setting out the background to the figures.  Dr Green, Shadow Accountable Officer from Medway’s Clinical Commissioning Group and Mark Devlin, Chief Executive from Medway NHS Foundation Trust also responded to Members’ questions.

Dr Smith-Laing explained that there was more than one method of measuring mortality figures but that the recent publication of the Dr Foster Hospital Guide had shown Medway Maritime’s figures to be the sixth poorest in the country.  He emphasised that this did not necessarily mean that the quality of care at the hospital was inadequate but the mortality ratio is also influenced by changes in coding practices at the hospital and an under-reporting of co-morbidities (diseases or conditions that coexist with a primary disease but they also stand on their own as specific diseases).  He also said that this form of measurement could not be used in isolation but should be examined alongside other data. 

Following extensive questioning, Members were assured that the hospital took the information very seriously and had developed action plans to address the recent high mortality ratio.   Some Members felt it would be helpful if the Committee were given advance notice of importance issues before the media releases them in order that they can give a balanced view on the interpretation of the data.

The Committee did, however, feel that this reporting of data was confusing to the public who would look at the figures in isolation.  It was emphasised that the Committee were not seeking to be critical of the hospital but needed to fulfil its scrutiny role in order to provide clarification for the residents of Medway.  A suggestion was made that; in order to understand the data collected in relation to mortality figures it would be helpful to have an update with some comparative data from local authorities with the same social and economic background to Medway in order to compare like with like.

Decision:

The Committee requested an update from the hospital in six months, which should include benchmarking information from similar local authorities.    

The Committee is asked to view the outcome of the feasibility study and determine whether a joint Health Overview and Scrutiny Committee with Kent County Council is required. 

Discussion:

The Chief Executives of Medway NHS Foundation Trust and Dartford and Gravesham Trust gave a presentation updating the Committee on the outcome of the feasibility study and commencement of the engagement process in relation to the proposed integration of the two trusts.

Members were informed that, in the event of subsequent service changes, they would be officially consulted on the proposals.  If the integration were to go ahead, the main services such as Accident and Emergency, Maternity services, Outpatients etc would remain in both hospitals.  In relation to some services such as laboratories the plan would be to have one main laboratory at one of the hospitals with a satellite service in the other.  Pathology services to the public would be no different in that respect as there would be no change to the places where blood is taken.

Some suggestions around public engagement were put forward and were accepted by the Chief Executive of Medway NHS Foundation Trust.  A view was put forward that there still seemed to be some concern from the public over the proposed integration and that more needed to be done to convince them of the merits of the case.  

Following questioning the Chief Executive of Medway NHS Foundation Trust gave details of recent service improvements for people in Medway suffering from Multiple Sclerosis and Parkinson’s disease who were now receiving regular treatments in Medway rather than having to travel to Kings College Hospital in London.  This enabled Kings College Hospital to expand other areas of its provision so was a benefit to them as well as to Medway residents.  He also stated that the medical staff at both hospitals were keen to drive the integration forward.

Decision: 

It was agreed that there should be an update to the Committee in March 2012 and that this should be added to the work programme.

A report on the consultation recently commenced with regard to the future plans for Shalder House in Gillingham. 

Discussion:

The Social Care Commissioning and Voluntary Sector Manager updated the Committee on the current position with regards to responses to the consultation with service users, staff and stakeholders in respect of the proposed closure of Shalder House.  Letters to 33 former users had been sent out and 10 responses had been received. 

While the responses were complimentary about the service which users received at Shalder House, the consensus was that the service users would have preferred to have received assistance to enable them to remain at home rather than having to use Shalder House.  Responding to a question she stated that in the event that any service user wanted to take advantage of a similar service to that offered at Shalder House there was spare capacity at Platters Farm.  She stated that the referral agency had also been consulted and had not raised any objections. 

In answer to a further question it was stated that Shalder House did not meet the decent homes standard and could therefore not be used for housing or temporary accommodation. 

Staff had until 16 December 2011 to submit counter proposals to closure but as yet no proposals had been received.

The Chief Finance Officer clarified the financial implications by stating that the money referred to in paragraph 7.3.8 had already been added to the Capital Allowance ‘pot’.

Decision:

The Committee noted the report.

This report sets out short term options in relation to adult social care mental health following notice being served on the current provider.  An addendum report will be sent from this Committee following the meeting for submission to Cabinet when it considers the item on 20 December 2011 – report to follow.

Discussion:

The Principal Officer Mental Health gave a detailed introduction to the report explaining that Kent and Medway NHS and Social Care Partnership (KMPT) had not delivered adequate social care outcomes.  For this reason notice had been served on them on 15 June 2011 with the contract due to end on 1 February 2012.

In view of the impending end to the contract he explained there was an urgent need to proceed with a short-term option of bringing the adult mental health social care team back into Council management, until such time as a longer-term solution could be found.  He felt there were exciting opportunities for the future to ensure that a whole system approach to adult mental health social care could be adopted.  He was also confident that by bringing the staff under the Council’s management in the interim the staff could receive much improved supervision and training to ensure excellent support and strengthened safeguarding for the benefit of service users.

The Committee unanimously welcomed the proposals contained in the report and the view was expressed that adult mental health social care had not received the focus and attention it merited for some time.

The Principal Officer Mental Health and the Director of Children and Adults responded to Members’ questions.   These largely related to the Transfer of Undertakings (Protection of Employment) Regulations 2006 (TUPE) and the future for the adult mental health social care team.  They stated that the staff concerned had been very much involved in discussions and that KMPT were leading the TUPE negotiations.  Responding to a question the Director of Children and Adults explained the Children and Adolescent Mental Health Service (CAHMS) provision in Medway, was a separately commissioned provision but the proposed arrangements for adult mental health social care will take into account the needs of service users who are parents.

The Committee welcomed the suggestion of scrutinising the plans, which will be submitted, to Cabinet in June about longer-term options.

Decision:

The Committee then recommended to Cabinet that:

(a)the Council carries out a review of its mental health social care strategy;

(b)the Council directly manages the delivery of mental health care management and services;

(c)  officers be instructed to evaluate and bring proposals to the Cabinet by June 2012 to determine the future delivery of mental health care management and services.

Councilllor Brake will be in attendance to be held to account for performance within his portfolio. 

Discussion:

The Portfolio Holder for Adult Social Care updated the Committee on performance within his portfolio, in particular in relation to:

·        Community Care

·        Health

·        Older People

·        Public Health and Health Improvement

·        Services for people with learning and physical disabilities

·        Telecare/Telemedicare

·        The development and progress of the Health and Wellbeing Board.

He explained a number of objectives where the Council was working in partnership to improve health and reduce inequalities including:

·        Community clean up

·        Green space renovation

·        Targeted employment support

·        Launch of the apprenticeship scheme.

He reported success in many initiatives including:

·        Tobacco control

·        Supporting healthy weight

·        Sexual health improvement

·        Harm caused by alcohol

·        Mental health promotion

·        Health trainers

·        Partnership with Young Offender Institute.

Reference was also made to the proposed integration between Medway NHS Foundation Trust and Dartford and Gravesham NHS Trust and to the consultation phase in relation to the papers presented to Cabinet in relation to the Vision for commissioning and providing adult social care services in Medway and Fairer contributions for fairer access to service.  He extended an invitation to Members of the Committee to observe the Lifeline service run by the Council.  Councillor Brake thanked officers, Members of the Overview and Scrutiny Committee and all those involved for the work they do on behalf of Health and Adult Services.

Councillor Brake was thanked for his presentation.

The Committee will scrutinise the second quarter monitoring report to assess progress against the Council Plan. 

Discussion:

The Director of Children and Adults gave a brief overview of the highlights and areas of challenge relating to adult social care.

Reference was made to the DVD shown at the Committee last year, which highlighted the benefits of service users taking up personalised budgets and the difference it had made to their lives.  Members expressed an interest in seeing the DVD again in the near future.

Decision:

Members noted outcomes achieved against priorities in the Council Plan.

This report presents the Council’s draft capital and revenue budget for 2012/2013 for areas that fall within the remit of this Committee.  This Committee is asked to forward any comments to Business Support Overview and Scrutiny Committee for its meeting on 2 February 2012.

Discussion:

The Chief Finance Officer gave a brief introduction to the draft capital and revenue budget, which he said, was based on the Medium Term Financial Plan 2012/2015.

Responding to a question he stated that the anticipated savings from the vision for adult social care had been factored into the budget already.

Decision:

Members noted the draft capital and revenue budget for 2012/2013.

This report asks Members if they wish to make any changes to the work programme and will set out plans for a Joint Health Overview and Scrutiny Committee with Kent County Council in the near future in relation to eating disorders and acute mental health beds which relate to both Medway and Kent. 

Discussion:

The Democratic Services Officer gave a brief introduction to the report and suggested that Members may wish to give consideration to moving the report on diabetes and quality assurance to the March meeting to allow a full debate on the two adult social care items which would be reported back to the January meeting following the consultation process.  Members agreed to this and requested that the item relating to the proposed integration of Medway NHS Foundation Trust and Dartford and Gravesham Trust be listed for the March meeting. 

The item relating to the future delivery of mental health care management should be brought back to this Committee prior to Cabinet in June.  The Democratic Services Officer was asked to check dates for the Committee in order to programme the report to a suitable meeting.

Decision:

It was agreed that:

(a)   the items on dementia and quality assurance issues scheduled for the next meeting should be delayed to 27 March 2012 meeting;

(b)   the proposed integration of Medway NHS Foundation Trust and Dartford and Gravesham Trust should be scheduled for 27 March 2012 meeting;

(c)   arrangements should be made to enable scrutiny of the proposals for the future delivery of mental health care management prior to them being considered by the Cabinet in June 2012.