Agenda and minutes

An apology for absence was received from Dr Ussher, Healthwatch Medway. 

To approve the record of the meeting held on 17 December 2015.

The record of the meeting held on 17 December 2015 was agreed as correct and signed by the Chairman. 

There were none. 

The Chairman stated that he would like to place on record the Committee’s thanks to Dr Barnett, the Director of Public Health, who was leaving the Council to work as Deputy Centre Director for Public Health England South East in a few week’s time.  He wished her well in her new job and, on behalf of the Committee, thanked her for her support to the Committee over the years.

Disclosable pecuniary interests

There were none.

Other interests

There were none.

This report is to inform the Committee of the details of the latest Care Quality Commission (CQC) inspection of Medway Maritime Hospital.

Discussion:

The Chairman welcomed the representatives from Medway NHS Foundation Trust to the meeting and emphasised that the Committee would not be going through the entire report.  However, a number of questions had been shared with the Trust prior to the meeting and he hoped they would be addressed as part of the introduction.  He welcomed the positive comments in the Care Quality Commission (CQC) Inspection report particularly in relation to maternity and gynaecological services and services for children and young people.

The Chief Executive of Medway NHS Foundation Trust (MFT) explained the background to the latest inspection of the hospital and stated that there was a long list of ‘must dos’ and a list of ‘should dos’ to be worked through but she was confident that the Trust had a strong communication plan and was assured that the good practice achieved in some areas of the hospital could be replicated elsewhere.

She set out some of the changes which had taken place within the Trust, including the strengthening of the Clinical Leadership Team, which were helping progress to be made, she did, however, stress that the Trust needed the support of partners with their plans.  The most important thing was for Medway Hospital to provide safe care and she was pleased that the CQC inspection had found staff to be caring.

The Chair of MFT responded to a number of questions forwarded to the Trust and stated that three additional Non-Executive Directors had been appointed to the Trust and she felt confident that the board now had the right skills mix and background to be able to successfully challenge the executive.

In relation to the questions about staff morale she stated that she was confident things would improve now there was more stability at the hospital and the Council of governors and Healthwatch Medway were engaging actively with staff which would enable staff to share any concerns.

At the invitation of the Chairman, the member of the Committee who attended the CQC Quality Summit on 8 January 2016 fed back on his experience of the event and made the following observations:

·         The event was well attended and the Care Quality Commission helpfully set the scene by explaining that Medway Maritime Hospital was built to cope with 45,000 attendances but was actually receiving 99,000 people in a year.  He stated that 1200 pieces of evidence had been gathered about the hospital and the importance of getting things right was emphasised bearing in mind the length of time the hospital had been classified as inadequate.

·         It was stated that the Chief Executive of the hospital had been very frank about the amount of work needed to bring about real improvements at the hospital. His view was that there was a real sense of camaraderie from the Clinical Directors and Board about getting the right systems and culture in place.  There was a zero tolerance in place about bullying at the hospital and drop in clinics had been set up to allow  ...  view the full minutes text for item 698.

The attached report sets out the response from Kent and Medway NHS and Social Care Partnership Trust (KMPT) in respect of the request for regular updates on the position with the acute mental health inpatient beds review.

Discussion:

The Chairman and Members of the Committee stated that the visit to KMPT services the previous week had been very helpful and informative.

The Executive Director, Operations, Kent and Medway NHS and Social Care Partnership Trust (KMPT) introduced a report on an update on acute mental health inpatient beds and welcomed the Member visit and extended an offer to those Members unable to attend on that date to visit in the future.

He stated that the Trust was subject to contractual negotiations at present with NHS England and the Trust Development Agency and he hoped to be able to report on this further at a future meeting.

He referred to a letter by the Chairman on behalf of the Committee and stated that the Trust would be mindful of the advice in that letter with regards to improving planning and design of new and innovative projects prior to receiving commissioning support in order to be able to demonstrate more efficiently the desired outcomes and whether they were being met.

Reference was made to the increase in numbers of younger adults in Kent and Medway being discharged from acute services which was up to 200 compared to 150 in June.  However, the number of admissions had not gone down.  Some detailed clinical work was currently being undertaken to assess the reason for this on a patient by patient basis. 

Discussion took place about the section 136 detentions and it was stated that the criminal justice diversion service was now being extended to Medway and Swale Police Stations in an attempt to reduce the number of such detentions.  There had been a positive response from the Police about the fact they now had a mental health practitioner to consult for advice at the Police station.

In response to questions the following points were made:

·         It was difficult for the Trust to recruit and retain staff on the basis that the close proximity to London meant that a number of staff were attracted to London because of the enhanced salaries on offer

·         Members stated that since the visit the previous week it was easier to appreciate the challenges facing the Trust and to understand that the prevalence of patients suffering mental ill health, and presenting in A&E in crisis, in Medway was far greater than most areas of Kent

·         Members were encouraged by the multi-agency integrated approach being taken at the hospital where Occupational Therapists, Psychiatrists, Crisis Resolution Home Treatment Team and Psychiatric Liaison staff all worked together

·         Following a question about waiting times it was stated that there was an average 4 week wait for an assessment and 12 week wait for treatment, 90% of patients were seen in 4 weeks and 99% treated in 18 weeks.  Handover of staff between shifts normally took no more than 30 minutes

·         Further to a question about an invitation received by a Member of the Committee to use talking therapies, the Chief Clinical Officer, NHS Medway CCG explained that these were in relation  ...  view the full minutes text for item 699.

Following the development of a Dementia Strategy for Medway in 2015, this report outlines progress achieved since the publication of the Strategy, and sets out the main findings following a more detailed needs and supply analysis of the current provision in Medway.

This exercise analysed population, needs, activity and costs data, and conducted extensive discussions with people with dementia and their carers across Medway, as well as other key stakeholders across the system.

The report concludes by identifying an action plan to take the work forward to the next stage of development.

Discussion:

The Assistant Director, Partnership Commissioning introduced the report on the dementia gap analysis and joint commissioning plan which had been written following the adoption of the Dementia Strategy by the Council and Clinical Commissioning Group (CCG).

As part of her introduction she paid tribute to Major Maurice Bernard, OBE who had died recently.  She stated that he had been very engaged in the process of developing dementia services until the time of his death.  His own personal case study had been quoted in the report.

In addition to the partnership working with the CCG there had been a significant engagement with public health in launching the dementia friends programme.  She explained that, following engagement with service users and carers it was clear that a strategic shift in practice was necessary to enable the offer to be less about a prescribed set of services, and more about flexibility, to fit with what may be required.

In explaining the content of the Dementia Commissioning Plan it was stated that it was planned to set up a Steering Group to oversee the implementation of the action plan, a Dementia Whole System Summit was also planned for 25 February 2016.

The Chief Clinical Officer, NHS Medway CCG emphasised the importance of early diagnosis as far as dementia is concerned but welcomed the shift in focus for the service.

Reference was made to a visit by a Member of the Committee to a dementia café the previous week and the view was put forward that although the group was well intentioned there seemed to be a gap in the service provided in that it was primarily directed towards the sufferer of dementia rather than there being any real support for the main carer/partner who are often struggling to cope with the life-changing and very significant behavioural changes in their loved one.   The Director of Children and Adults Services reminded Members that there would shortly be a Member in-depth task group on ‘how far has Medway gone in becoming a dementia-friendly community’ and suggested that this feedback could be fed into the scoping meeting for that review.

The Deputy Director, Children and Adults informed Members that there would be a refresh of the Carer’s Strategy shortly, which he would bring to the Committee in due course.  The carers themselves are contributing to the document so are very much involved in the content.

A Member asked what was being done about minority groups and what contacts were in place.  The Assistant Director, Partnership Commissioning explained that existing forums were being used to contact minority groups and that being inclusive was at the heart of the Alzheimer’s Society work.  A request was made that this information is included in the report back in August 2016.

In response to a question it was stated that it was not possible to specify the exact number of people with dementia who were among the numbers of patients waiting for discharge from the hospital.  It was stated that the NHS Emergency  ...  view the full minutes text for item 700.

Discussion:

The Democratic Services Officer introduced the work programme report and reminded the Committee that the report on dementia would need to be added to the work programme.

In relation to the meeting with the Emergency Care Improvement Team at the hospital with the Chairman, Vice-Chairman and spokespersons of the Committee she hoped to be able to notify Members of the date of this meeting shortly.  She advised that it was likely to be held in early March 2016.

Decision: 

The Committee:

(a)  Agreed to add to the work programme an item on Urgent and Emergency Care Review on a date to be agreed;

(b)  Noted the outcome of the Joint Health Scrutiny (JHOSC) meeting with Kent County Council held on 8 January 2016 as set out in paragraph 5 of the report;

(c)  Noted that the report on ‘blue light’ conveyances for Swale residents had been dealt with as a briefing note;

(d)  Noted that the Chairman, Vice-Chairman and spokespersons of the Committee, with a representative from adult social care, would be meeting with the Emergency Care Improvement Team at the hospital shortly.