Agenda and minutes

To approve the record of the meeting held on 20 August 2013.

The record of the meeting held on 20 August 2013 was agreed as correct and signed by the Chairman. 

Apologies for absence were received from Councillors Igwe, Kearney and Watson. 

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)              Disclosable pecuniary interests and other interests

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.

(B)            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.

There were none. 

This report sets out the outcome of the unannounced inspection by the Care Quality Commission, which reviewed maternity services at Medway Maritime Hospital.  The Chief Executive of Medway NHS Foundation Trust and the Chief Nurse from Medway Maritime Hospital will be present to introduce the report, which was requested by the Committee.

Discussion:

The Chief Executive of Medway NHS Foundation Trust gave an introduction to the unannounced inspection report from the Care Quality Commission (CQC) in relation to maternity services at Medway Maritime Hospital. 

He stated that he and the staff of the hospital were very disappointed with the outcome of the inspection, which he said was undertaken using new methodology covering six standards.  The findings against these outcomes was as follows:

• Respecting and involving people who use our services – minor concern – action required
• Care and welfare of people who use services – moderate concern – action required
• Management of medicines – moderate concern – action required
• Staffing – major concern – enforcement action taken
• Supporting workers – major concern – enforcement action taken
• Assessing and monitoring the quality of services – major concern – enforcement action taken

He explained that the ratio of midwives to patients had formerly been a recommendation of 1:29 and the hospital had been working towards that target.  The ratio was now a requirement and the aim was for the hospital to be compliant with that target by the end of the year.  Already the hospital was at a ratio of 1:30 following efforts to recruit new midwives to the service and he emphasised that the recruitment process had been robust to ensure that high quality staff were employed.  Following comments made by the Committee he admitted that some basic errors had been made in the maternity service, that some processes had not been adhered to while there was a shortage in staff and accepted that the inspection had brought to light very important omissions and gaps in service, which he agreed was unacceptable.  He emphasised that there was an enthusiasm and determination to address all the issues raised speedily.

He referred to close working with commissioners at the CCG on the antenatal pathway to refresh and modernise the service.  Responding to Members’ questions in particular relating to:

• Auditing processes in maternity services
• Staff training and appraisals
• Bereavement training
• Consistency and good practice across the service
• Ongoing availability of the Birth Place
• The importance of dealing with mental health issues promptly

He detailed the actions of the trust in rectifying the areas of concern, particularly in relation to training, appraisals, support of staff and more robust auditing of processes within the maternity service.  He stated that where good practice was identified it was rolled out across the service without delay.  In relation to bereavement training the Chief Nurse at the hospital stated that there was a senior midwife who was the designated midwife and she had specific training and experience dealing with bereavement.  The Birth Place would on occasion still need to be closed but as more staff joined the hospital these closures would be less frequent.

He also outlined the assistance being given to the department from a senior midwife in London as external challenge and support for the service, which had been very helpful.

The Head of Midwifery responded to Members’ specific queries  ...  view the full minutes text for item 525.

To consider any changes required to the work programme, add two items to the December work programme and consider a request from the Health and Wellbeing Board in relation to the task group on health inequalities. 

Discussion:

The Chairman made the following announcements:

• He referred to receipt of clarification from the mental health trust about the current bed numbers in use at A block, Medway Maritime Hospital, which had been circulated to all Members of the Committee on Friday.  He stated that the topic of mental health already featured on the agenda for 18 December meeting with the implementation plan for the proposed acute mental health beds reconfiguration being considered and possibly also the response from the Secretary of State to the Committee’s referral back in August.
• A petition signed by 1,654 people relating to St Mary’s medical centre in Strood, calling for the roll over of the existing contract to Doctor Pancholi had been received.  The petition had been handed to two of the ward members, Cllrs Chitty and Etheridge, and he understood Cllr Hubbard was fully supportive of it.  Democratic Services would be processing the petition under the Council’s petitions scheme.  He stated that whilst it would not be appropriate for the Committee to seek to influence NHS decisions relating to individual contracts of employment the petition would be referred to the NHS England (Kent and Medway) office with a request for the Committee to receive an update on the continuity of provision at St Mary’s at its next meeting on 18 December to which the lead petitioners would be invited.  A request would be made for the Chairman and spokespersons to be kept informed of development affecting provision in the meantime.  An initial briefing from NHS England (Kent and Medway) had been sent to Members of the Committee on Friday.
• The physiotherapy team formerly based at Medway Maritime Hospital will be moving to their new clinic at MCH House, 21 Bailey Drive in Gillingham on Wednesday 20 November.  The new clinic, he had been assured, was purpose designed with easy parking and access by public transport.

Note: There was no discussion under this item on the recommendation from the Health and Wellbeing Board for a Healthwatch Medway representative to be added to the membership of the Health Inequalities Task group.

Decision: 

(a)   It was noted that the report of the Mental Health Task Group and the outcome of the Committee’s referral to the Secretary of State of the proposed reconfiguration of acute mental health inpatient beds would be added to the work programme for 18 December 2013.

(b)   It was noted that a report on St Mary’s medical centre would be added to the 18 December meeting items and NHS England (Kent and Medway) and lead petitioners invited to attend.