Agenda and minutes

The Chairman referred to the recent sad death of Councillor Nick Bowler, a long-standing Member of the Council, who had died on 12 October. Councillor Murray spoke of her shock at hearing the news of Councillor’s Bowler’s death. His family appreciated the support he had received from the NHS after his diagnosis. She had worked with Councillor Bowler for over 20 years and he would be greatly missed. 

A minute’s silence was then held in memory of Councillor Bowler.

Apologies for absence were received from Councillors Adeoye and Thompson.

To approve the record of the meeting held on 17 August 2021.

The record of the meeting of the Committee held on 17 August 2021 was agreed and signed by the Chairman as correct.

There were none. 

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct.  Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

 Other significant interests (OSIs)

There were none.

Other interests

Councillor Ahmed, in relation to agenda item 5, disclosed that she worked for Rehman Chishti MP who had responded to the public consultation referred to in the report, but she had not been involved in this response.

This report outlines the initial headline results from the formal public consultation on the proposal to relocate Ruby Ward from Medway Maritime Hospital to a new purpose-built facility in Maidstone.

Discussion:

Members considered a report from the Kent and Medway Clinical Commissioning Group (CCG) which outlined the initial headline results from the formal public consultation on the proposal to relocate Ruby Ward from Medway Maritime Hospital to a new purpose-built facility in Maidstone. Set out in a supplementary agenda were full, detailed reports and analysis of the responses to the consultation and the activity undertaken to deliver the consultation.

The CCG advised that a range of methodologies had been used in the consultation process and there had been a particular focus on deprived areas to elicit views and feedback, particularly on travel and transport issues, as requested by the Committee.

In summary, a majority of respondents agreed the proposed move would improve care and address needs, but some challenges and concerns had been identified with regard to travelling and visiting. The CCG would carry out further work to look at what mitigations could be put in place to support patients and families. Some other potential sites had been suggested from respondents to the consultation and these would be evaluated to see if they met the criteria, the outcome of which would be included in the CCG’s decision-making business case and also reported to Members for information.

The CCG thanked the Committee for their engagement with the process. 

The following issues were then discussed:

·       Mitigations – it was emphasised that any mitigations put forward needed to be implemented and Members kept informed, noting similar circumstances in the past where promised mitigation did not take place, albeit  under the responsibility of a different leadership team.

·       Consultation process – noting that the Independent Report on the consultation stated that, of all the respondents from across the catchment population, Medway and Swale residents disagreed most with the proposals and the potential loss of this service in their locality, how people were selected for phone interviews and why no libraries in Medway were used was queried. In addition, disappointment was expressed that only two online survey responses had been received from Medway and Swale residents. The reference in the Independent report to two respondents from Medway and Swale was in relation to a comment that the proposal would not represent an improvement in the service. In response to the point about there being only two online survey responses from Medway and Swale, Members were advised that the online survey was only one of the methodologies used to seek feedback in the consultation, and other methodologies such as focus groups, attendance at patient and community group meetings, and telephone interviews were used to gather responses from across the catchment population including those from Medway and Swale. An additional 100 telephone interviews had been commissioned mid-way through the consultation specifically to boost the number of responses from those in more deprived areas, including in Medway and Swale. It was explained that the people chosen for phone interviews had been selected randomly. There had been a focus on more deprived areas, as requested by the Committee, with 200  ...  view the full minutes text for item 414.

The attached paper from the Medway NHS Foundation Trust updates Members on recent inspections by the Care Quality Commission.

Discussion:

Members considered a report from the Medway NHS Foundation Trust updating Members on recent inspections by the Care Quality Commission.

During the course of the discussion Councillor Van Dyke disclosed that she was a public governor of the Trust but did not consider this presented a conflict of interest.

The following issues were discussed:

·       Improvement plan and recovering elective services – in terms of how this was progressing and the impact of Covid, the Chief Executive of the Trust advised that Covid had had a devastating impact on services. At the peak of the backlog around 1,000 people were waiting 52 weeks for treatment. This figure had now reduced to about 200 and it was a priority to clear this backlog by the end of the financial year. The pandemic had meant many cancer services having to be paused but the Trust was now complying with its 2 week wait target. There was a focus on the recovery of cancer and elective care services and the backlog of very serious incidents had been cleared.

The point was made that any improvements were from a low base and the more streamlined action plans were welcomed. A comment was also made that the report offered some reassurances and it was acknowledged that ratings moving from inadequate following the most recent CQC inspection was a significant achievement.

·       Working with external mental health providers to improve waiting times for crisis beds and travel arrangements – in relation to this action, the point was made that there was a need for an overall mental health strategy and KMPT could help with this. In response the Chief Executive commented that the Trust received good support from KMPT operationally and there were good escalation procedures. There were delays in respect of patients in crisis admitted to the ED in getting to a bed, but these tended to be younger. A paediatric area in the hospital had been refurbished to make the environment better and safer. The Trust was working with KMPT to improve matters but there was no easy solution.

·       Review of oversight of clinical incidents and embed an effective system to learn from such incidents – disappointment was expressed with regard to the conclusion that a learning culture was not embedded in the Trust, and that there was a lack of effective governance around serious incidents and a lack of appetite for organisational learning. The Chief Executive advised that the backlog of serious incidents had been cleared and there was a target to clear lower-level incidents by the end of November.

·       Ensuring that where medical care service risks are identified, mitigation is put in place in a timely manner – regarding this target, the point was made that lines of accountability were clear but were not always affective and there had been a lack of oversight from leadership team.  The Chief Executive commented that he was confident lines of accountability were now clearer.

·       Ensuring the Emergency Department always has enough staff with the  ...  view the full minutes text for item 415.

This report provides an overview of the joint Kent and Medway Dementia Strategy that is being developed bythe Kent and Medway Clinical Commissioning Group (CCG), the Kent and Medway NHS and Social Care Partnership Trust (KMPT), Medway Council and Kent County Council. This brief provides an overview for the Strategy, the vision, and the chapter headings with assurance that Medway Council is engaged in the development and scrutiny of this Strategy.

Discussion:

Members considered a report which provided an overview of the joint Kent and Medway Dementia Strategy that is being developed by the Kent and Medway Clinical Commissioning Group (CCG), the Kent and Medway NHS and Social Care Partnership Trust (KMPT), Medway Council and Kent County Council. The paper  provided an overview for the Strategy, the vision, and the chapter headings with assurance that Medway Council is engaged in the development and scrutiny of this Strategy.

The point was made that diagnoses were still taking too long, including deprivation of liberty assessments. Members were advised that all organisations involved in the strategy had action plans and as gaps were recognised actions were put in place to address them.

It was suggested that the Member Task Group on dementia (How far has Medway gone in becoming a dementia friendly community) should be taken into account in the developing the strategy.

Decision:

The Committee agreed to note the direction of travel at this preliminary stage of the Kent and Medway Dementia Strategy.  

This report provides information on the number, type and other information on adult social care complaints received during the period April 2020 - March 2021. It also highlights some examples of the positive things people have said about the provision of adult social care in Medway over the same period and the service improvements Medway Council has made because of lessons learnt from complaints.

Discussion:

Members considered this annual report which provided information on the number, type and other information on adult social care complaints received during the period April 2020 - March 2021. The report also highlighted some examples of the positive comments about the provision of adult social care in Medway over the same period and the service improvements the Council had made because of lessons learnt from complaints.

The following issues were discussed:

·       Poor communications – the point was made that a common factor in complaints was insufficient or poor communication. Officers advised that staff were encouraged to not respond until they had the correct answer to a query. Many complaints were a result of invoicing errors and new software had been introduced which it was hoped would reduce the number of complaints. The point was made that the Council needed to learn from these errors and the Assistant Director – Adult Social Care commented there had been pressures in the team and that charges were an emotive subject. On occasion, other organisations would tell a person that their adult social care would be free. In general, when dealing with complaints it was important that they were responded to quickly and by a senior person.  

·       Local Government and Social Care Ombudsman decision – the point was made that the decision of the Ombudsman that the Council was atfault in relation to a complaint about the Council’s refusal to make an exception to the rule preventing a mother from using direct payments to pay for care from her daughter seemed unusual given this was not permitted under the rules. The Assistant Director – Social Care commented this had been a very challenging case and involved another local authority which had made a decision about a service which a Medway member of staff had incorrectly agreed could be continued.

·       Complainants’ ethnicity – noting 96% of complainants were white/British, how this compared with the ethnicity of the population was queried.  Members were advised that the ethnic background of the population in Medway was 90% white, 5% Asian and 3% black.  Officers hoped to be able to identify how this compared to service users in order to improve the complaints process.

Decision:

The Committee agreed to note the report.

This summarises performance in Q1 2021/22 on the delivery of the priority relevant for this Committee: Supporting Medway’s people to realise their potential.

Discussion:

Members considered a report which summarised performance in Quarter 1 2021/22 on the delivery of the priority relevant for the Committee: Supporting Medway’s people to realise their potential.

The following issues were discussed:

·       Rate per 100,000 of self-reported 4-week smoking quitters aged 16 or over – the Director of Public Health advised that this measure was now on target. In response to whether Covid had impacted on performance, Members were advised that before the pandemic performance was improving so a stretch target has been set. The importance of not smoking had continued to be emphasised and the public health team had focused on higher risk people and moved messaging to more online.

Reference was made to a rise in pregnant women smoking and whether the public health team planned to work in communities to address this was questioned. The Director of Public Health commented the team was able to work flexibly with communities and had also worked with NHS England so staff could signpost pregnant women who were smoking to get support.

The possibility of a briefing for members on smoking cessation work was made and Members were advised this could involve people who had benefited from this service.

·       Long covid – it was suggested that when the Committee came to scrutinise long covid services this should include the impact of this on social care. Members were advised that the data on long covid for Medway could be provided.

Decision:

The Committee agreed to note the Q1 2021/22 performance against the measures used to monitor progress against the Council’s priorities.

Discussion:

Members considered a report regarding the current work programme.

Decision:

The Committee agreed the changes to the work programme as set out in paragraphs 2.2 and 2.3 of the report.