Agenda and minutes
PDF 280 KBVenue: Meeting Room 2 - Level 3, Gun Wharf, Dock Road, Chatham ME4 4TR
Contact: Michael TurnerDemocratic Services Officer
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To approve the record of the meeting held on 30 September 2014. Minutes: The record of the meeting held on 30 September 2014 was agreed as correct and signed by the Chairman. |
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Apologies for absence Minutes: Apologies for absence were received from Councillors Kearney and Maisey. |
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Urgent matters by reason of special circumstances The Chairman will announce any late items which do not appear on the main agenda but which he has agreed should be considered by reason of special circumstances to be specified in the report. Minutes: There were none. |
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Declarations of interests and whipping (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.
Members should also ensure they disclose any other interests which may give rise to a conflict under the council’s code of conduct.
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. Minutes: Disclosable pecuniary interests
There were none.
Other interests
Councillor Etheridge declared an interest in any reference to mental health as her son was in the care of mental health services. |
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Medway Maritime Hospital - CQC Inspection This report advises the Committee of the findings of the unannounced Care Quality Commission (CQC) Inspection of the Emergency Department at Medway Maritime Hospital on 26 August 2014. The Inspection report was published on 26 November 2014.
Representatives of Medway Clinical Commissioning Group and the Medway Foundation Trust will be present to respond to Members’ questions and provide an update on progress in improvements being made in response to CQC findings. Minutes: Discussion:
Members considered a report on the findings of the unannounced Care Quality Commission (CQC) Inspection of the Emergency Department at Medway Maritime Hospital on 26 August 2014. The Inspection report had been published on 26 November 2014.
The Chair of the Medway Foundation Trust outlined the main findings of the CQC inspection in August 2014 and provided an update on progress in improvements being made in response to the CQC’s findings. The Chair advised that CQC had carried out a further inspection on 9 December. The Trust’s Chief Operating Officer then described in detail the measures that had been put in place in response to the August inspection, which mainly related to the Emergency Department (ED) and included the following:
With the exception of the redevelopment of the ED there were, within reason, no restrictions on funding to implement these improvements.
The Chief Operating Officer then reported on the informal feedback the Trust had received from the CQC following the 9 December inspection. CQC, in informal feedback, had recognised that small improvements had taken place and expressed their confidence in the new management team. They had witnessed evidence of better teamwork between doctors and nursing staff. The CQC had observed that people were not being released quickly enough from theatres and documentation was poor. In conclusion, the CQC still rated the Trust as inadequate but were encouraged to see some improvements.
The Chairman thanked the representatives from the Trust for their honest appraisal of the issues.
The Committee then had a wide ranging discussion and raised a number of questions and issues as summarised below:
The Action Plan in response to the CQC Inspections
Some members expressed frustration that the CQC expected dramatic improvements in such a short period of time. There was also some concern at the numerous action plans produced by the Trust since it had gone into special ... view the full minutes text for item 586. |
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Petition on Health and Lifestyle Trainers (HALT) Service This report advises the Committee of a petition presented at the Council meeting on 16 October 2014 calling on the Council to save the Health and Lifestyle Trainers Service. The lead petitioner has exercised her right under the Council’s Petitions Scheme to refer the matter to this Committee for consideration. The report also addresses further questions from Members in relation to this matter. Minutes: Discussion:
Members considered a report regarding a petition presented at the Council meeting on 16 October 2014 calling on the Council to save the Health and Lifestyle Trainers Service. The lead petitioner had exercised his right under the Council’s Petitions Scheme to refer the matter to this Committee for review. The report also addressed further questions from Members in relation to this matter.
Mr Bennett, the Lead petitioner, spoke about the unique nature of the service and its successes. He acknowledged not all of the targets had been met but pointed out these had been extremely ambitious for a new service. The service increasingly focused on delivering behaviour change, often working with people least likely to engage with public health initiatives. Mr Bennett felt that the way in which the Council had described the decision about the end of the contract had been confusing. In any event the effect of the decision had been that this valuable service had come to an end and staff had been made redundant. Finally Mr Bennett referred to legal advice he had received which stated there was a weakness in the Council’s diversity impact assessment which meant Cabinet had not been able to reach a proper view on this matter.
Councillor Cooper, the Local Member, spoke in support of the petition and commented on the vital work the service provided in one of the most deprived wards in the country. The decision to end the contract also called into question the viability of the Sunlight Centre.
A member of the public who attended a support group at the Sunlight Centre also spoke in support of the service and asked the Council to reconsider its decision.
The Director of Public Health responded and apologised for any unintentional confusion caused by terminology used in the report. She advised the Committee to carefully distinguish between the contract with the current service provider (Sunlight) for the HALT service having now come to an end and the fact that a decision had yet to be taken whether or not to procure the service again. She agreed with comments made by the lead petitioner about the effectiveness of public health services but given the significant financial challenges facing the Council decisions about the award of contracts had to be carefully taken and it was prudent to pause the process until the Council’s budgetary position was clearer. The Council would continue in the meantime to provide a range of public health services.
A member proposed that Cabinet should reconsider its decision taken on 28 October 2014 to note the expiry of the existing contract given that as a result of the petition further relevant information (such as the equality and diversity assessments) had come to light which showed there was more to this issue than at first appeared. The HALT team had provided a service across Medway and it was arguable that the decision to end the contract would in the end cost the Council more due to the type of ... view the full minutes text for item 587. |
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This report provides an overview of the current context in which this service is commissioned. It then considers progress made during the last year and challenges faced. Minutes: Decision
The Committee agreed to defer this item until its next meeting. |
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Acute Mental Health Inpatient Bed Review Update The attached report sets out the response from Kent and Medway NHS Social Care Partnership Trust in respect of the request for regular updates on the position with the acute mental health inpatient bed review. Minutes: Discussion:
The Interim Director of Operations, Kent and Medway NHS and Social Care Partnership Trust (KMPT) introduced a report which set out the response from Kent and Medway NHS Social Care Partnership Trust in respect of the request for regular updates on the position with the acute mental health inpatient beds review. In particular the Committee was updated on progress in enhancing community based mental health services and the impact this was having on reducing the use of acute inpatient beds. Reference was made to a new therapeutic hostel in Medway and the success of a new Crisis Café.
The Interim Director responded to members‘ questions as follows:
95% Occupancy Rate - in response to a question about how much importance the Interim Director attached to the 95% occupancy rate, the Interim Director replied that it was a useful measure but bed availability and providing the right service were the most important issues. A supplementary question expressed some concern that this was a different answer to that given at previous meetings.
Value for money - a Member commented that it was apparent not enough beds had been commissioned and the significant amounts being spent on out of area beds (up to £2m) called into question the Trust’s business case given that the Committee had previously been told that lack of finance was the reason why extra beds could not be provided in Medway. A member asked what the business case was for commissioning external beds and how many were needed for clinical reasons as opposed to a lack of availability. Dr Green commented that the focus should be on providing proper care not the number of beds. He accepted out of area beds were expensive but suggested that overall it provided some economies, as permanent extra beds in Medway were not needed. He added that external bed use was now much lower and there was evidence the strategy was working. The Interim Director also felt that the provision of appropriate services was more important than the number of beds per se.
Comparative information - a member asked if comparative information on the provision of mental health beds was available. An undertaking was given to send members a link to a website which allowed mental health services to be compared.
Crisis Plans - in response to a comment about the importance of people being quickly readmitted when another crisis arose, the Interim Director replied that improvements had been made in ensuring that patients had an effective crisis plan. In addition, services were being developed to allow a crisis response team to respond to crisis referrals within one hour.
Complaints and patient engagement – In response to a question if the Trust felt there were still too many complaints, both the Interim Director and Dr Green replied that complaints were encouraged as a means of improving services. Conferences for service users and carers were being used by KMPT as a mechanism for feedback. The Healthwatch Medway representative commented that recent KMPT stakeholder ... view the full minutes text for item 589. |
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Annual Public Health Report of the Director of Public Health 2013/14 This report presents the Annual Public Health Report of the Director of Public Health for 2013/14, which focuses on the health of Medway’s older population and makes recommendations for Medway Council and partners. An audit of progress against the Annual Public Health Report for 2012/13 is also included.
The 2013/2014 Annual Public Health Report will be circulated separately to Committee Members and made available on the Council’s website. Additional documents: Minutes: The Director of Public Health presented the Annual Public Health Report for 2013/14 which focused on the health of Medway’s older population and made recommendations for Medway Council and partners. An audit of progress against the Annual Public Health Report for 2012/13 was also included. Members welcomed improvements in the levels of childhood obesity in Medway as compared to national averages.
Members welcomed the significant reduction in the number of hospital admissions for falls in the over 65 population.
A member referred to measures to combat illegal tobacco and referred to difficulties in persuading HMRC to help in pursuing prosecutions. The Director of Public Health undertook to follow up on this issue.
A member referred to the disappearance of large numbers of bungalows from the housing stock in Medway and suggested that public health make representations to amend the local plan to help alleviate this given that bungalows were the most suitable type of housing for elderly people.
A member felt that the references in the report to the private rented sector and fuel poverty should be strengthened and that Public Health should seek opportunities to raise the standard of housing via the Council’s Housing Strategy. In response the Director of Public Health commented that her team worked closely with colleagues in housing and referred to a winter warmth scheme being funded by Public Health.
Decision:
The Committee noted the Annual Public Health Report 2013/14 and the audit of progress against the recommendations in the Annual Public Health Report 2012/13 and thanked Dr Barnett and her team for their work in producing the report. |
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Six Month Update on Health Inequalities Task Group Review This report provides an update to Members on progress in implementing the recommendations of the Review of Health Inequalities Task Group. Minutes: Members considered a report on progress in implementing the recommendations made in the report of the Review of Health Inequalities in Medway undertaken by the Scrutiny Task Group during October 2013 – February 2014 and approved by Cabinet on 13 May 2014.
Members welcomed the new licensing post which allowed evidence to be gathered to promote public safety and public health through the licensing agenda.
The pensioner forum representative commented that some GPs continued to on occasion dismiss concerns raised by the elderly as being inevitable due to old age and felt this was a health inequality that needed to be addressed. Dr Green replied that this was unacceptable and any examples should be reported.
A member requested further information on the tool produced by public health for addressing health inequalities through proportionate universalism and the Director of Public Health agreed to circulate this to members.
Decision:
The Committee noted the progress made against the recommendations from the Review and that further updates on health inequalities would be included in the annual report from the Health and Wellbeing Board. |
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Capital and Revenue Budget 2015/2016 This report presents the Council’s draft capital and revenue budgets for 2015/2016 relative to this Committee. Minutes: Discussion:
The Committee discussed a report on the Council’s draft capital and revenue budgets for 2015/16. The Head of Finance Strategy introduced the report and invited the Committee to consider the draft budgets and forward any comments to the Business Support Overview and Scrutiny Committee for onward referral to Cabinet and full Council.
With reference to the range of proposed savings in adult social care, as set out in paragraphs 5.4 to 5.9 of the report, members asked for assurances that any savings proposed in budgets used to fund home care would not compromise quality of care for these vulnerable service users.
The Director of Children and Adults Services advised that the Dynamic Purchasing System was a framework model involving a range of providers and designed to achieve reduced costs whilst sustaining high quality provision. She assured the Committee that the implementation of the new system would be carefully monitored and that monitoring would include consideration of direct service user feedback. The Director also stated that Medway did not use 15 minute appointments in social care.
The Committee discussed proposed savings from the Adult Social Care Transport budget and noted that the reduction in expenditure would be achieved by changes in the Service Level Agreement between the C and A and RCC Directorates as a consequence of the transfer of Napier and the Enhanced Care Unit to Agincare.
With regard to the proposed introduction of an administration fee for self-funders (paragraph 5.5 of the report), the proposal to consider capping community care costs (paragraph 5.6) and the introduction of a Dynamic Purchasing System (paragraph 5.7) Members asked if any consultation had been undertaken with service users likely to be affected. The Director advised that these proposals were still under consideration and that decisions had yet to be made as part of the budget setting process. She confirmed there would be consultation with service users.
With reference to the possibility of capping community care costs in conjunction with implementation of the Care Act, the Director of Children and Adults undertook to clarify the definition of an “older person” in light of the statement in paragraph 5.6 of the report they would be excluded from such a policy. She advised the Committee that work was underway to look at how such a change could be structured and consideration would be given to the approach being adopted by other local authorities in the South East.
The Committee expressed concern at the reduction from three to one administrative post in the Mental Health Social Work Team, which officers had advised was inadequate to safely carry out legal duties under the Mental Health Act 2007 and to ensure safeguarding procedures are followed. In light of discussion earlier in the meeting about Mental Health services, progress in the provision of acute mental health inpatient beds and the reliance on health and social care working together to achieve the best outcomes for patients, service users and their families the Committee agreed to recommend the Cabinet to reinstate ... view the full minutes text for item 592. |
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Council Plan - 2014/2015 Quarter 2 Performance Monitoring This report summarises the performance of the Council’s Key Measures of Success for July to September (Quarter 2) 2014/2015 as set out in the Council Plan 2013/2015. Minutes: Discussion:
The Director of Children and Adults introduced the report which summarised the performance of the Council’s key measures of success for the Council’s key priority: “Adults maintain their independence and live healthy lives” as set out in the Council Plan 2013/15, for the period July – September (Quarter 2) 2014/15.
She highlighted progress with key projects and the significance of the Better Care Plan in supporting the improvement journey for Medway Maritime Hospital with a particular focus on reducing usage of the Accident and Emergency Department.
Decision:
The Committee noted the Quarter 2 -2014/15 performance against the key measures of success used to monitor progress against the Council Plan 2013/15. |
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This item advises Members of the current work programme and allows the Committee to adjust it in the light of latest priorities, issues and circumstances. It gives Members the opportunity to shape and direct the Committee’s activities over the year. Minutes: Discussion:
The Head of Democratic Services introduced the report. With reference to paragraphs 3.2 and 4.2 in the report she advised the Committee that since the agenda –planning meeting discussion of a report on the Dementia Strategy had been re-programmed for discussion by this Committee at its next meeting on 27 January 2015 rather than 31 March as printed in the agenda.
It was also noted that one item falling within the terms of reference of this Committee had been added to the Forward Plan of Cabinet decisions since the agenda- planning meeting; this was a report on the Contract for a Homecare Services Framework which would be considered by Cabinet on 16th December 2014.
The Committee was advised that the Children and Young People Overview and Scrutiny Committee would be responding to the invitation from the CQC to submit comments ahead of its inspection of Sussex Partnership Foundation Trust (which provides Children and Adolescent Mental Health Services for Medway).
It was requested that all members of this Committee should have an opportunity to review the draft response from this Committee to be submitted to the CQC ahead of the inspection of KMPT in March 2015.
Decision:
(a) The Committee agreed the addition of reports on a Dynamic Purchasing System, Dementia Strategy and the new approach to CQC Inspection of GPs to the agenda for the Committee meeting on 27 January 2015
(b) The Committee agreed an Annual Report on Care Homes should be presented each September
(c) The Committee agreed to submit comments to the CQC ahead of its inspection of KMPT on 16 March 2015 and to delegate authority to submit a commentary, based on evidence available to the Committee over the last year or so, to the Deputy Director Customer Contact, Leisure, Culture, Democracy and Governance, in consultation with the Chairman, Vice Chairman and Opposition Spokespersons.
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