Agenda and minutes

To approve the record of the meeting held on 9 October 2012 and the special meeting held on 16 October 2012.

The record of the meeting held on 9 October, and of the special meeting held on 16 October 2012, were agreed and signed by the Chairman as correct. 

Apologies for absence were received from Councillors Kearney and Rodberg. 

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.

In line with the training provided to members by the Monitoring Officer members will also need to consider bias and pre-determination in certain circumstances and whether they have a conflict of interest or should otherwise leave the room for Code reasons. 

Councillor Pat Gulvin declared a personal interest in agenda item 9 (Local Changes to Primary Care) on the basis that she was a patient at the Walderslade surgery reference in the report and her mother is a patient of Dr Dabestani.  Councillor Adrian Gulvin declared a personal interest in the same item on the basis of being a patient at Walderslade surgery.

Councillor Purdy declared a personal interest in agenda item 6 (Member item – Age Concern) on the basis of having been a former trustee of Hopewell Centre.  She reserved her right to speak on the item.

Councillor Christine Godwin declared a personal interest in any reference to Medway Older People’s Partnership as she chaired that body.

Councillor Murray declared a personal interest in any reference to public health on the grounds that her daughter works in public health.

During the discussion on agenda item 5 Councillor Christine Godwin declared a personal interest in Kent and Medway NHS and Social Care Partnership Trust due to her husband being a non-executive director there.  She left the meeting during the discussion.

The Portfolio Holder for Adult Services will attend the meeting to give account of his performance against targets in his portfolio within the remit of this Committee.

Discussion:

The Portfolio Holder for Adult Services presented his report on performance within his portfolio over the past year and looking forward to the next year.

He referred to the following topics:

• An update on the work of the Shadow Health and Wellbeing Board
• Transfer of public health into the Local Authority from the NHS
• Health Improvement programme including stop smoking scheme, illegal supply and sale of cigarettes, healthy weight, and prevention of alcohol related harm
• Reference was made to the healthy eating task group and the recommendations from that group concerning restricting of fast food outlets near schools
• The excellent support from the voluntary sector
• Safeguarding vulnerable adults
• Personal budgets
• Carers and the valuable work they do
• Extra care housing
• Adult mental health
• New electronic care system called Core Logic being introduced across Children and Adults Directorate to ensure efficient joining up of information/data
• Balfour Day Centre
• Age Concern
• LINk/Healthwatch

He also paid tribute to the officers who support the Committee and Children and Adults Directorate and to the Director of Public Health for their work over the past year.

Members asked questions in relation to the following:

• Progress with the Balfour Centre – it was explained that various options were being looked at by Medway Community Healthcare
• Acute mental health inpatient review
• Merger between Medway NHS Foundation Trust and Dartford and Gravesham Trust
• Topics in which the portfolio holder took a particular interest
• Safeguarding adults
• How many extra care units there were in Medway?
• Inspections of adult social care establishments
• Concern was expressed that the officers involved in planning and licensing sections may not be aware of the recommendations of the Healthy Eating Task Group in relation to curtailing the setting up of fast food establishments near to schools.  Discussion also took place with regards to small shops near schools selling fast foods (The Director of Public Health was requested to look into this).
• Dignity of residents in Medway’s care homes
• An update was given on an invoice received from Kent and Medway NHS and Social Care Partnership Trust (KMPT) over which there was a dispute with the Council.  It was stated that part of that invoice had still not been paid on the grounds that the Council maintained the number of service users was incorrect

(Cllr Christine Godwin left the meeting during discussion on KMPT).

Decision:

Councillor Brake was thanked for his presentation.

This report sets out a response to a matter, raised by Councillor Osborne in relation to the long-term future of Age Concern Chatham at their Hopewell Drive site.

Discussion:

Councillor Osborne introduced his Member item relating to the long term future of Age Concern, Chatham at their Hopewell Drive site.  He thanked the Assistant Director, Adult Social Care and officers for their time and efforts in dealing with this matter.

The Assistant Director, Adult Social Care responded to Councillor Osborne’s questions and those of other Members of the Committee in relation to this item.  He clarified the following points:

• In relation to paragraphs 3.2 and 3.3 of the report he stated that these were separate events
• In relation to paragraphs 3.6 and 3.7 a letter had been sent to the Council requesting a meeting with the Social Care Commissioning Team to discuss the viability of the site.  The Council offered to cover the potential liabilities of Age concern, Chatham up to a maximum value of £69,800 plus VAT as applicable to enable the charity to continue to operate over the period February 2013-2014
• The landlord of Hopewell Drive had been very supportive and helpful during the negotiations and had now agreed to a 10 year lease, at a modest rent, to Age Concern UK to allow for some certainty and stability
• With regards to bids from other interested parties to operate a day centre in Chatham he explained that as such premises are not regulated by the Care Quality Commission it was vital for the Council to be vigorous in checking the alternative providers very carefully to ensure they could offer what was needed.  In this instance Age Concern UK had the necessary experience and background to make their offer a better one for Medway residents
• In relation to an inventory of assets from Age Concern Chatham he undertook to write to them expressing the Committee’s wish that such an inventory is drawn up and arrangements made for equipment donated by local Councillors to remain for the benefit of residents of that area

Decision:

The Committee

(a)   thanked the Assistant Director, Adult Social Care and officers from the Council involved in the negotiations with Age Concern for work they had done to bring about a successful outcome;

(b)   requested the Assistant Director, Adult Social Care to discuss with Age Concern Chatham the request from Committee Members that they draw up an asset inventory and make arrangements for equipment donated to them from local Councillors to remain for the benefit of residents of Chatham (a briefing note to be sent to Councillors on the outcome).

This report sets out quarter 2 performance against the Council Plan objectives for 2012/2013.

Discussion:

The Assistant Director, Adult Social Care introduced the quarter 2 performance report and updated Members in relation to ASC 8 Carers receiving needs assessment or review and a specific carer’s service or advice and information by stating that recruitment was ongoing for additional posts to deal with these assessments.

In relation to NI 156 number of households living in temporary accommodation he stated, in response to a question that he would talk to colleagues from other directorates within the Council to assess the impact of changes to the benefit system from April 2013 to numbers of people living in temporary accommodation.  He also undertook to provide a briefing for the Committee on the definition of temporary accommodation.  A breakdown of the figures in relation to this indicator was requested.

With regard to PB 7 Number of Medway Businesses taking part in the healthy workplace initiatives the Director of Public Health undertook to liaise with Members outside of the meeting about the organisations involved in these initiatives and to discuss with Councillor Mackness some suggestions he had about further organisations who could get involved in the future.  A request was also made for a breakdown of the Medway businesses already involved in the scheme.

Decision:

The Committee requested:

(a)   a briefing note from the Assistant Director, Adult Social Care in relation to NI 156 explaining the definition of temporary accommodation and a breakdown of figures in relation to this indicator;

(b)   a briefing note from the Director of Public Health on the Medway businesses currently involved in the healthy workplace initiatives;

(c)   the Director of Public Health to discuss with Councillor Mackness outside of the meeting details of further contacts he has about further organisations to contact in regard to healthy workplace initiatives.

This report sets out the Council’s draft revenue and capital budget for 2013/2014. 

Discussion:

The Director of Children and Adults gave a brief introduction to the draft capital and revenue budget for 2013/2014.

The Director of Public Health confirmed, in response to a question, that the public health funding which is anticipated shortly, would be ring fenced.

Some Members expressed their concern at the reference in paragraph 4.5 of the report to the key assumption of a zero uplift for general inflation on the basis that it was a known fact that inflation was at 4.5% currently.   The point was also made that there did not appear to have been any reference to the potential impact of changes to the benefit system in April and how this was being built into the budget.  Members were disappointed not to be able to question the Chief Finance Officer on these points. 

A request was made for the Committee to have a separate briefing with the Chief Finance Officer on the budget in the New Year.

Decision:

The Committee:

(a)   noted the draft capital and revenue budget for 2013/2014;

(b)   expressed their extreme disappointment that there was no representative from Finance at the meeting;

(c)   requested a separate briefing from the Chief Finance Officer early in the New Year to enable the Committee to ask questions on the budget.

This report sets out proposed changes to GP practices in Medway.  The first proposal relates to Dr Raval, Dr Dabestani and Partners from Walderslade Medical Centre.  The second relates to Dr Patel’s surgery in Broadway in Gillingham. 

Discussion:

The Development Manager, Medical Quality, NHS Kent and Medway gave a brief introduction to two proposals in relation to changes to primary care in Medway.

(a)               Dr Raval, Dr Dabestani and Partners – proposal to close branch site at Walderslade Medical Centre (Princes Park)

It was stated that the proposal was for Drs Ravel, Dabestani and Partners to cease operations at their Walderslade Medical Centre (Princes Park) consolidating their services within their other practices.

In relation to the distances set out on pages 59 and 60 of the agenda Members felt that these were seriously underestimating the actual distances involved in walking between the sites.  Concern was expressed about the difficulty in accessing the Robin Hood Lane site and the lack of parking.  It was felt that it would have been more sensible to consolidate at Princes Park, which had ample parking at the local Morrisons site.

A query was also raised about the presence of Dr Dabestani at Walderslade Village Surgery as a Member of the Committee had been told that he was not there in spite of his name being listed on the available doctors at the surgery.

The Development Manager, Medical Quality from NHS Kent and Medway undertook to look into these issues raised and report back.

Decision:

(a)   The report was noted;

(b)   The Development Manager, Medical Quality from NHS Kent and Medway undertook to look into the issues raised at the meeting and report back to Members of the Committee.

(b)       Dr Patel, Broadway, Gillingham – joining Woodlands Family Practice

A clarification was given on page 55 of the agenda paragraph 2.3 that the current surgery in Broadway will close on 1 March 2013 not 31 March 2013 as stated.

As with the previous item Members felt that the distances between surgeries set out in the report were inaccurate and requested that these are checked.

Members welcomed the proposals put forward in relation to Dr Patel in anticipation of his retirement in order to provide his patients the opportunity for long-term stability of care.

Decision:

(a)   The report was noted;

(b)   The Development Manager, Medical Quality from NHS Kent and Medway undertook to look into the issue re distances raised at the meeting and report back to Members of the Committee.

This report sets out the changes to the out of hours arrangements in Medway, arising from the implementation of the national NHS 111 scheme and affecting the Medway On Call Care (MedOCC) service, in particular the service provided by MedOCC at Rochester Healthy Living Centre

Discussion: 

The Head of Commissioning, Medway Commissioning Group, assisted by the NHS 111 Programme Lead, NHS Kent and Medway and the Assistant Director of Operations, Medway Community Healthcare introduced the report on changes to out of hours arrangements in Medway.

It was stated that NHS 111 model for Kent and Medway, Surrey and Sussex is based on the national specification for the service.  The funding for this service would be from the reduction in the cost of calls, decommissioning NHS Direct and transferring the cost of the call handling and GP telephone consultation resources from local out of hours providers.  The contract for NHS 111 in Kent and Medway, Surrey and Sussex was awarded to South East Coast Ambulance Trust in partnership with Harmoni.

The Head of Commissioning, Medway Commissioning Group explained that the proposal would be monitored closely from the outset and reviewed formally after a few months.   She stressed that, in order to ensure resilience of the system, there would be no reductions in face to face appointments which would remain at approximately 36,000 and provided by Quayside House or via a home visit.

She responded to Members’ questions including the following:

• The future of MedOCC – it was confirmed that MedOCC would be retained at Medway Hospital
• Concern was expressed at the proposed closure of the service at Rochester Healthy Living Centre although it was stated that this had only ever been for weekends and for a small percentage of people
• The pilot projects had been undertaken in Durham, Darlington and Luton and Dunstable but were on a different model to that being adopted in Kent and Medway, Surrey and Sussex
• In relation to maintaining professional focus for those health practitioners involved in NHS 111, to ensure they do not lose touch with face to face contact with patients, it was stated that they will be subject to a peer audit by other health care professionals on a regular basis
• The call centres for NHS 111 in this area would be based at Dorking and Ashford
• Concern was expressed that students from Mid Kent College had received invitations to apply for positions at Ashford as Health Advisers for NHS 111.  It was stated that all applicants for the posts would be carefully vetted, interviewed, tested and subject to rigorous training over a four week period
• Members felt that it would be important to assess the impact of the changes after a twelve month period and it was hoped that it would be a system which would not be complex to access once a person dials 111

Decision:

The Committee noted the report and requested a review of the new model after a twelve month period.

This report advises Members of the current work programme for discussion in the light of latest priorities, issues and circumstances.  This report gives Members the opportunity to shape and direct the Committee’s activities and requests early consideration of a potential topic for an indepth review.. 

Discussion:

The Democratic Services Officer gave a brief introduction to the report by drawing Members’ attention to paragraph 5 of the report which set out the process for planning topics for in depth scrutiny reviews for 2013/2014.  She reminded Members they needed to ensure they passed any ideas to the Chairman or spokespersons of the Committee prior to 28 February 2013.

In relation to paragraph 6 of the report she stated that consideration had been given to the possible transfer of children’s health from Children and Young People Overview and Scrutiny Committee to this Committee.  Following concerns expressed at a recent meeting of Children and Young People Overview and Scrutiny Committee she stated that further work would be done with Members around the topic and no further action needed to be taken at present.

Decision: 

(a)   The proposed timetable and process for determination of the next round of in depth reviews was noted;

(b)   It was agreed that all Members of this Committee should send ideas for topics within the remit of this Committee to the Chairman and Opposition spokespersons (with a copy to the Head of Democratic Services) by no later than 28 February 2013 having regard to the criteria previously adopted for selection of topics as set out as Appendix 2 to the report;

(c)   It was noted that no further action was proposed in relation to the suggestion of moving health from Children and Young People Overview and Scrutiny Committee to this Committee at present;

(d)   The update from Medway NHS Foundation Trust set out in paragraph 7.2 of the report was noted.