Agenda and minutes

To approve the record of the meeting held on 26 June 2012.

The record of the meeting held on 26 June 2012 was agreed and signed by the Chairman as correct.

To receive apologies for absence. 

Apologies for absence were received from Christine Baker and Councillors Kearney, Mackness and Shaw. 

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 member need only disclose at any meeting the existence of a disclosable pecuniary interest (DPI) in a matter to be considered at that meeting if that DPI has not been entered on the disclosable pecuniary interests register maintained by the Monitoring Officer.

A member disclosing a DPI at a meeting must thereafter notify the Monitoring Officer in writing of that interest within 28 days from the date of disclosure at the meeting.

A member may not participate in a discussion of or vote on any matter in which he or she has a DPI (both those already registered and those disclosed at the meeting) and must withdraw from the room during such discussion/vote.

Members may choose to voluntarily disclose a DPI at a meeting even if it is registered on the council’s register of disclosable pecuniary interests but there is no legal requirement to do so.

Shirley Griffiths declared a personal interest by virtue of being a Member of Medway NHS Foundation Trust and South East Coast Ambulance Trust and as a trustee of Medway Crossroads Carers Trust. 

This report updates the committee on the Medway NHS Foundation Trust’s response to the Council’s concerns relating to its changes to parking fee concessions for Blue Badge holders. 

Discussion:

The Chief Executive of Medway NHS Foundation Trust, accompanied by the Director of Governance and Risk of the Trust, introduced the item by explaining that the Trust had decided that its approach to car parking had not been as equitable as it could have been.  The aim of the review had been to bring about a fairer system where the needs of the most vulnerable and those on low incomes were still protected but that those who were able to pay did so, including blue badge holders.  The concessions for people in this category had been increased as part of this review and more publicity was being given to the fact that concessions were available, on the Trust’s website and also by the production of information leaflets.  A copy of the sample leaflet was handed round to the Committee.  It was made clear that the Trust were willing to consider additional concessions and had already included further groups of people to the original list. 

The Chief Executive of the Foundation Trust stated that while there had not been any public consultation the proposals had been discussed by the Board of Governors at the Foundation Trust where there had been a mixed response to the plans.

Members of the Committee then put forward their strong objections not only to the decision to charge blue badge holders parking at the hospital but that no thought had been given to consulting either with the public or the Overview and Scrutiny Committee prior to the implementation of the new charges.  The view was put forward that the decision had brought about a backlash of public objections, which had been directed at Councillors.  In view of this, Members requested that in future the Trust should consider letting Members know in advance of similar changes to policy regardless of whether the Trust had a duty to consult.  The Chief Executive of Medway NHS Foundation Trust acknowledged that lessons had been learned from the introduction of the charging but emphasised that the Trust had not considered consulting the Council on the grounds that the decision did not affect clinical outcomes.

A number of small amendments to the leaflet were suggested at the meeting and the Chief Executive of Medway NHS Foundation Trust invited further comments, acknowledging that if there were to be a merger with Dartford and Gravesham Trust there would need to be a harmonisation of policy.  He also acknowledged that Trusts across the county had taken very different approaches to car parking charges.  Responding to a question the Director of Governance and Risk stated that the introduction of charges for blue badge holders had not increased the cost of administration as existing staff dealt with the concessions.  There was also an acknowledgement by Medway NHS Foundation Trust that the car park at Medway Maritime hospital did need investment and improvements for which additional revenue expenditure was necessary.  Reports of staff using parking spaces reserved for the disabled were being dealt with rigorously by the  ...  view the full minutes text for item 305.

This report informs the committee of proposals to change the model of care for vascular surgery across Kent and Medway and requests the committee to decide whether or not it considers this issue to be a substantial variation.

Discussion:

The Associate Director, South of England Specialised Commissioning Group introduced the review of vascular services.  She explained that the review was in response to a change in service specifications for the way that vascular services were carried out to bring about a hub and spoke model.  There was potential for the hub to be at the Kent and Canterbury Hospital in Canterbury with Medway Maritime Hospital being retained as a ‘spoke’.  For the majority of Medway patients they would be treated as usual at Medway Maritime Hospital but the more complex and highly specialised cases would be treated either in London or at the new hub in Canterbury.  Careful attention would need to be given to the impact of other vascular support services at Medway Maritime Hospital such as trauma, maternity and interventional radiography to ensure that there was not a detrimental affect on those services.  The Chief Executive of Medway NHS Foundation Trust confirmed this.  He also stated, following concern that services seemed to be leaving Medway rather than Medway retaining specialist services, that there was a need to look at a broader range of service users.  It was no longer possible to retain an isolated method of commissioning purely for Medway residents.  By broadening horizons to include other geographical areas there were more possibilities of attracting specialist services to the area.  It was necessary for a hospital to support around 750,000 patients in order to develop as a centre of specialism.

Responding to a question regarding the numbers of Medway residents potentially affected by this decision, it was stated that 15-30%, less than 200 patients across Kent and Medway and (approximately 86 patients in Medway) would be affected.  It was also confirmed that having received surgery at Canterbury Medway residents would be returned to Medway as soon as possible.  Members placed emphasis on the need to get the transfer of residents back to Medway dealt with effectively with a comprehensive handover process.

The Associate Director stated that commissioners were currently undertaking a gap analysis and developing an action plan as part of a South of England Strategic Health Authority review.  In response to a question, she confirmed that patients were still able to choose between specialised services in London or Canterbury.

There was no overall agreement as to whether the proposed services changes constituted a substantial variation or not.  Some Members felt this was not necessarily a substantial variation for Medway but requested further details as to the improved outcomes and service improvements, referred to in the report, along with the action plan and gap analysis before taking a decision.

Decision:

The South of England Specialised Commissioning Group were asked to report back on their findings from the gap analysis and action plan in September to the Chairman and opposition spokespersons on the basis that a report would come back to the Committee should those Members consider the proposal to constitute a substantial service change at that point.

The annual report provides information on the number and type of adult social-care complaints, comments and compliments Medway Council have received during the period April 2011 to March 2012.

Discussion:

The Assistant Director, Adult Social Care introduced the annual complaints and compliments report April 2011 to March 2012 and responded to Members’ questions.

He referred to the simpler system for dealing with complaints in that there were now only two stages to a complaint, consideration by the Council and then reference to the Local Government Ombudsman beyond that, as necessary. 

Responding to questions about how the Council learned from complaints he stated that before a complaint could be closed a form had to be completed explaining what action was needed and learning arising from the complaint.  Information was fed back by a variety of means but included discussion at team meetings and one to one meetings/Professional Development Reviews etc.  He confirmed that the Council did have a whistleblowing policy and that in the main operated a ‘no blame’ culture, however the needs of service users were paramount and therefore action would always be taken where appropriate.

Following a further query he stated that there were no particular themes of complaints emerging and that the Council was comparable with others in terms of the level of complaints received.  He confirmed that he would be happy to share some anonymised examples of complaints with Members if they found that helpful.  It was stated that it is possible for clients to put forward verbal complaints rather than in writing and that the Social Care Complaints Manager, interpreters and advocates assist those people who struggled to put their complaint into words.

Decision:

The report was noted.

This report sets performance against the Council’s Key Measures of Success for the first quarter of 2012/13. 

Discussion:

The Assistant Director, Adult Social Care introduced the report on performance against the Council’s Key Measures of Success for the first quarter of 2012/2013 and he and the Research and Review Team Manager responded to Members’ questions.

The Assistant Director, Adult Social Care highlighted the areas where the Council was performing well along with some areas where more progress was needed.  In relation to the delayed transfers from hospital he stated that he was pleased to report continued good progress in relation to there being no delayed transfers of care attributable to the Council.  Further work continues across the whole system to reduce even further the number of delays with performance in Medway being very good and improving.

Following a question, it was agreed that a briefing note will be provided to Members giving more detail on PB7 Number of Medway Businesses taking part in the healthy workplace initiatives to explain why the target had been set at 36 businesses.

It was also agreed that there will be a report back to Members on whether or not initiatives such as Surestart were used to get messages over to the public about healthy weight and healthy lifestyles.

Decision: 

Further information, in the form of a briefing note, was requested on:

(a)   PB7 – to explain why the target had been set at 36 businesses; and

(b)   Whether or not people accessing Surestart and similar initiatives in Medway were given advice on healthy weight and healthy lifestyles

This report advises the Committee of the consultation paper issued by the Department of Health on 12 July 2012 setting out proposals for Local Authority Health Scrutiny.  The Committee is asked to agree a response as set out in paragraph 3 of the report.  A full copy of the consultation document is attached at Annex A. The deadline for responses is 7 September 2012. 

Discussion:

The Head of Democratic Services introduced a report outlining a consultation paper issued by the Department of Health setting out proposals for local authority health scrutiny and responded to Members’ questions.

She explained the major changes brought about by the Health and Social Care Act 2012 including the introduction of a Health and Wellbeing Board, changes relating to Healthwatch and the setting up of Clinical Commissioning Groups.  Reference was also made to a series of meetings underway locally to refresh the Council’s protocol on NHS consultations on service reconfigurations and information sharing.

Members felt that the suggested responses were helpful but in respect of paragraph 3.12 a) it would be useful to strengthen the sentence to say that it is essential that further direction is provided on the circumstances in which Foundation Trusts have to now consult on service reconfigurations.

Decision: 

The suggested responses to the consultation on health scrutiny regulations as set out in the report were agreed for submission to the Department of Health with the following amendment to paragraph 3.12 a) to read ‘Medway Council’s Health and Adult Social Care Overview and Scrutiny Committee consider it is essential that further direction is given on the circumstances in which Foundation Trusts have to now consult on service reconfigurations as the current legislation appears to be drawn very widely and is open to interpretation.

This report sets out the proposed work programme for the committee for 2012/13. 

Discussion:

The Democratic Services Officer gave a brief introduction to the work programme.  Responding to a question as to whether the Committee had scrutinised the Public Finance Initiative (PFI) at Dartford she stated that the Committee had not specifically scrutinised the matter.  However, the Assistant Chief Executive, NHS Medway stated the matter had been referred to during a debate on the potential merger of Medway NHS Foundation Trust with Dartford and Gravesham Trust.  It may well be that this would generate further debate at the next meeting.  She undertook to work with the Democratic Services Officer to consider what information could be shared with the Committee bearing in mind some of the merger documents would be commercially sensitive.

A request was made for an update on the adult social care changes and the tendering process for the Linked Service Centres and it was agreed that this would be dealt with as an all Member briefing. 

Referring to the delay of the item on dementia being considered by the Shadow Health and Wellbeing Board.  A suggestion was made that further discussion was needed on the relationship between the Health and Wellbeing Board and Overview and Scrutiny and this could be picked up in the meeting underway to review local protocols.  It was also being discussed at a regional level.

The Chairman pointed out that this was the Assistant Chief Executive of NHS Kent and Medway’s last meeting of the Committee before handing over to the Shadow Accountable Officer from Medway Commissioning Group.  He, and other Members of the Committee, thanked her for her support of the Committee and wished her well for the future.

Decision: 

It was agreed that:

(a)   a report on podiatry to respond to the issues raised by this Committee and a report back on the outcome of the service review be brought by Medway Community Healthcare to the October meeting;

(b)   Members noted (i) the update on dementia services had been delayed with a date to be agreed; (ii) the attendance of the portfolio holder for adult social care would be delayed to 19 December 2012 meeting (iii) the initial update of the Joint HOSC contained in paragraph 3 of the report (iv) the report on Quality Assurance scheduled for 9 October will move to 19 December 2012 meeting;

(c)    The item on the application for foundation trust status from Kent and Medway NHS and Social Care Partnership Trust would be the subject of a special meeting of the Committee;

(d)   further discussion on the relationship between the Health and Wellbeing Board and this Committee would be picked up in the meeting underway to review local protocols between the Council and NHS;

(e)   the Assistant Chief Executive of NHS Kent and Medway should work with the Democratic Services Officer to determine what documentation could be shared with Members in relation to the PFI at Dartford;

(f)     an all Member briefing be arranged to update Members on the implementation of the adult social care changes