Agenda and minutes

Health Select Commission - Thursday 17 April 2014 9.30 a.m.

Venue: Town Hall, Moorgate Street, Rotherham S60 2TH

Contact: Dawn Mitchell 01709 822062 Email: dawn.mitchell@rotherham.gov.uk

Items
No.	Item
80.	Declarations of Interest View the background to item 80. Minutes: There were no declarations of interest made at this meeting.
81.	Questions from members of the public and the press View the background to item 81. Minutes: There were no members of the public and press present at the meeting.
82.	Communications View the background to item 82. Minutes: (1) Response to Youth Cabinet The response to the question from the Youth Cabinet (Minute No. 70 of 13^th March, 2014) was attached to the agenda. (2) Joint Health and Overview Scrutiny Committee 2 reports had been published following the Leeds Children’s Heart Surgery Services review – the Mortality Case Review and the Family Experience. The third report, Governance Review, would be published later in the year:- Mortality Case Review Overview Findings - Clinical management of the cases examined showed medical and surgical care to be in line with standard practice - Case mix of surgical conditions and patients operated on was in keeping with comparable Children’s Cardiac Surgical Units in the United Kingdom - The cases reviewed were predominantly of high or significant complexity often with additional contributory risk factors Family Experience Finding - A number of themes around care planning and support for families emerged based on the views and experience of 16 children and their families Both reports made recommendations that had formed the basis for an action plan that the LTHT and the Unit were implementing – Service development, audit programme development. (3) Suicide Prevention Conference The conference, held in Rotherham, had been attended by Councillors Beaumont, Dalton and Steele representing the Select Commission. It had been a well attended thought provoking event with some very good speakers. CARE about Suicide, the Guide to help universal workers prevent suicide, had been launched. The Chairman highlighted the work of the Youth Cabinet on self-harm which had been featured at the conference. (4) The Rotherham Foundation Trust Quality Accounts The first draft would be circulated at the end of April/first week in May for Members to consider before the Trust attended the meeting in June. (5) Healthwatch It was proposed that there be a new standard agenda item “Issues from Healthwatch”, either verbal update or written report, to enable Healthwatch to raise issues/concerns they wished to bring to the Select Commission’s attention. (6) Yorkshire Ambulance Service Quality Accounts To be submitted shortly. Resolved:- That “Issues from Healthwatch” be included as a standing item on future agendas.
83.	Minutes of the Previous Meeting PDF 76 KB View the background to item 83. - Meetings held on 13^th March, 2014 Additional documents: Question from Youth Cabinet , item 83. PDF 23 KB Minutes: Consideration was given to the minutes of the meeting of the Health Select Commission held on 13th March, 2014. Resolved:- That the minutes of the meeting held on 13^th March, 2014, be agreed as a correct record for signature by the Chairman.
84.	Health and Wellbeing Board PDF 72 KB View the background to item 84. - Minutes of meetings held on 19^th February 2014 and 23^rd March, 2014 Additional documents: Minutes , 26/03/2014 Health and Wellbeing Board , item 84. PDF 59 KB Minutes: Consideration was given to the minutes of the meetings of the Health and Wellbeing Board held on (i) 19th February and (ii) 23rd March, 2014. Councillor Wyatt, Chairman of the Health and Wellbeing Board, drew the Select Commission’s attention to the following issues:- - Rotherham Active Partnership (Minute No. S79) – 6 monthly reports to the Board with the sports agenda meshing more closely with the health agenda, including funding streams - Joint Strategic Needs Assessment Consultation (Minute No. S81) – additional issues had been referred for inclusion within the document which was available on the website - Peer Review (Minute No. S85) – the offer of a Peer Review had been taken up and may involve members of the Select Commission - National Energy Action Fuel Poverty (Minute No. S86) – a lot of learning had come from the project - Better Care Fund (Minute No. S87) – work in progress - Novation to Healthwatch (Minute No. S88) – would allow Healthwatch to operate as a social enterprise - Mental Health and Learning Disability Services (Minute No. S90) – a pilot was being run in Rotherham with RDaSH and South Yorkshire Police for those with mental health issues involved in the criminal justice system to ensure they were in the correct placement Resolved:- That the minutes of the meetings be received and the contents noted.
85.	RDaSH - Quality Accounts PDF 4 MB View the background to item 85. - Karen Cvijetic, Head of Quality Improvement, to present Minutes: Karen Cvijetic, Head of Quality Improvement, gave the following powerpoint presentation:- What is a Quality Report? - Coalition Government White Papers set out the vision of putting Quality at the heart of everything the NHS did - Key component of the Quality Framework was the continuing requirement for all providers of NHS Services to publish Quality Accounts - This was the opportunity to enable the OSC to review and supply a statement as to whether “the report was a fair reflection” of RDaSH services - 2013/14 was the 6^th Quality Report produced by RDaSH 2013/14 Quality Performance - Care Quality Commission (CQC) Registered with no conditions - CQC Inspections 11 inspections of Trust services 3 of Learning Disability Services in Rotherham 1 Trust-wide inspection - Compliant with essential standards of quality and safety reviewed - CQC Mental Health Act Monitoring Visits 18 monitoring visits of Trust Mental Health Inpatient Services 7 monitoring visits of Rotherham Mental Health Inpatient Services - Compliant with some minor improvement actions - Commissioner-led Quality Visits Adult Mental Health Community Services Positive feedback - Quality improvement Initiatives Child and Adolescent Mental Health Services Trust Quality Improvement Team - Commissioning for Quality Indicators (CQUIN) Patient Safety i.e. Safeguarding, Patient Safety Thermometer Clinical Effectiveness i.e. Outcome Measures, Transitions Patient Experience i.e. Patient/Carer Survey Review of Quality Markers 2013/14 Three domains of quality:- - Patient Safety - Clinical Effectiveness - Patient Experience Plus - Our people/staff Examples of Quality Improvement Work - Patient Experience · Respecting, involving and empowering patients · Improving care through patient feedback · Improving access · Making service/treatment information available - Patient Safety · Changes in practice through lessons learned · Environmental safety/accessibility · Personalised care planning · Records management · Safeguarding - Clinical Effectiveness · Access to supervision · Implementing evidence based practice · Staff engagement in clinical effectiveness activity · Development of care pathways · Development of outcome measures Process for 2014 - Consultation with Select Commission - Engagement with Trust Council of Governors – regular agenda item/draft Quality Report for comment - Draft Quality Report to Trust Clinical Governance Group and Board of Directors Quality Priority for 2014/15 - Clinical Leadership – developed by Board of Directors, Council of Governors and Business Divisions Francis Declaration - Trust Francis Declaration jointly signed off by Board of Directors and Council of Governors in December, 2013 - 4 Francis priorities for 2014:- Culture Engagement Non-professionally quality staff Whistleblowing National and Public Health Priorities 2014/15 - Tier 4 CAMHS - 7 day working - Better Care Fund - Closing the Gap - Public Health – provision of Substance Misuse Services and possible retendering of services Local Commissioning Priorities 2014/15 - Consideration of investment in priority areas following the outcomes of the reviews - A review of Mental Health and Learning Disability Services - A review of the Learning Disabilities Assessment and Treatment Unit and Community Services - Development of a comprehensive CAMHS Strategy - Development of care pathways and packages (Mental Health Payment and Pricing Systems) Next Steps - Receive Select Commission’s comments for ... view the full minutes text for item 85.
86.	RTFT - Progress Update on Action Plan PDF 1 MB View the background to item 86. - Martin Havenhand, Trust Chair, to present Additional documents: 2 Year Operational Plan Board 3 4 14 FINALf , item 86. PDF 323 KB Minutes: The Chairman welcomed Martin Havenhand (Trust Chair), Tracey McErlain-Burns (Chief Nurse), Jan Bergman (Director of Transformation/Deputy CEO) and Kerry Tate Maskill (Communications Officer) to the meeting who were present to give an update on the Operational Plan 2014-16. The following presentation was given on the 2 Year Operational Plan:- Vision - To ensure patients are at the heart of what we do, providing excellent clinical outcomes and a safe and first class experience Mission - To improve the Health and Wellbeing of the population we serve, building a healthier future together Values - Safe, Compassion, Together, Right First Time, Responsible and Respect will underpin the way we work and define the culture we wish to build within the organisation Strategic Objectives - Develop high quality and safe services that effectively met the changing healthcare needs of the population it served - Achieve clinical and financial sustainability - Work with partners across the local health economy to ensure sustainability of wider healthcare provision - Ensure that it had the leadership capability and capacity to deliver the strategy and services - Ensure that its governance arrangements were fit for purpose and help shape the behaviours that would achieve the strategy - Meet its regulatory requirements - Develop and maintain an appropriately skilled and engaged workforce to meet service needs now and in the future - Develop a culture based on their values and behaviours Trust Key Priorities Strategy - Develop 5 Year Strategic Plan - Transformation Programme Action Plan - Board Development Programme Structure - Appointment of CEO and Executive Team - Clinical Management Re-structuring - Board Committee Structure - Assurance Framework - Risk Management People - Staff Communication and Engagement - People Performance Management - Performance Management Framework - Stakeholder Engagement Plan - Governor Engagement Operational Objectives - To provide quality and safe health services - To address the underlying financial deficit - To successfully implement a £22M Cost Improvement Programme - To produce and implement Clinical Strategies which: Identify those services that sustain a stand-alone Trust Identify those services for increased collaboration Identify those services to be provided by other providers - Deliver a Board Development programme - Establish the Executive Team - Implement Clinical Re-structuring - Embed and sustain new Board and Committee structures - Introduce and embed the Board Assurance Framework and Risk Management Strategy - Develop a staff communication and engagement process - Introduce the Trust Performance Management Corporate Report and monitor performance throughout the plan period - Undertake performance appraisal for all staff by Q1 - Develop stakeholder engagement plans - Agree a forward work plan with Governors Quality Objectives Safe - Mortality - Harm Free Care Reliable - Waiting Times Caring - Friends and Family Test All Domains - Nationally and locally mandated quality requirements CQUIN - 9 focus areas Organisational Risk - Quality of Care - Commissioning and Competition - Operational Delivery - Cost Improvement Programme - Workforce Operational Challenges - Unscheduled Care – in particular ageing population and increase in ... view the full minutes text for item 86.
87.	Access to GPs Scrutiny Review PDF 37 KB View the background to item 87. Additional documents: Access to GPs Appendix , item 87. PDF 582 KB Minutes: Consideration was given to a report presented by Councillor Hoddinott, Chair of the Review Group, which set out the findings and recommendations of the above Scrutiny Review. The 7 main aims of the Review had been:- · Establish the respective roles and responsibilities of NHS England and GP practices with regard to access to GPs · Ascertain how NHS England oversees and monitors access to GPs · Identify national and local pressures that impact on access to GPs – current and future · Determine how GP practices manage appointments and promote access for all patients · Identify how NHS England Area Team will be responding to changes nationally · Consider satisfaction data from the GP Patient Survey on a practice by practice basis and to compare Rotherham with the national picture · Identify areas for improvement in current access to GPs (locally and nationally) A full scrutiny review was carried out and evidence gathering began in October, 2013, concluding in March, 2014. It had comprised of round table discussions and written evidence from health partners, reviewing the National GP Patient Survey data, desktop research and fact finding visits to 4 GP practices. The national and local pressures that impacted upon access to GPs were recognised. There was reduced funding, shortages of GPs and nurses and premises that were not always suitable for the increasing range of services now delivered at practices. Patient demographics with a growing and ageing population, coupled with the prevalence of ill health and long term conditions and local deprivation in some areas meant increasing demand. This required adequate resourcing to ensure good access to services for all patients. Patients’ experiences of accessing GPs varied from practice to practice with some long waiting times reported. Expectations and preferences were changing and it was a question of striking a balance between clinical need, patient expectations and convenient access with practices needing to work with their patients to develop systems that worked well for both. The review had made 12 recommendations:- 1. Patients’ experiences of accessing GPs vary from practice to practice, therefore NHS England needs to ensure that patients’ views on access are reflected in the forthcoming Personal Medical Services contract re-negotiations and five year commissioning plan. 2. The continuation of the Patient Participation Directed Enhanced Service in 2014/15 should be used to ensure patients are well informed and empowered through the Patient Participation Groups to challenge pool access and suggest improvements. 3. Although recognising the importance of clinical need, the expectations and preferences of patients are changing and practices should explore more hybrid and flexible approaches to appointments, such as having part of each day for sit and wait slots. 4. NHS England should maintain access to interpretation services for GPs with an emphasis on professional services, supported by training for GPs and practice staff to increase confidence in using telephone services where appropriate. 5. NHS England should review their current interpretation provision to see if economies could be achieved through signing up to Rotherham MBC’s framework agreement which is open to partner agencies. ... view the full minutes text for item 87.
88.	Health Select Commission Work Programme Update PDF 53 KB View the background to item 88. Minutes: Janet Spurling, Scrutiny Officer, presented a progress report on the Select Commission’s work programme and delivery to date together with future agenda items and potential themes for 2014/15. Items suggested to date for the proposed programme for the Health Select Commission were as follows:- Mental Health Special Schools – Nurses and School Nursing Service Commissioning Support Unit – Continuing Health Care Items still to be considered but scheduled for June/July were:- Continence Better Care Fund – final action plan Public Health Annual Report Health and Wellbeing Strategy Workstreams – Poverty and Prevention and Early Intervention Emergency Care Centre Healthwatch Rotherham Foundation Trust Quality Accounts Discussion ensued on the inclusion of Mental Health within the proposed programme and the broad spectrum it encompassed. It was suggested that a scoping paper be produced to establish which areas should be concentrated on. Resolved:- (1) That the achievements made so far be noted. (2) That Mental Health and Wellbeing underpin the Health Select Commission’s 2014/15 work programme.
89.	Date and Time of Next Meeting View the background to item 89. - Thursday, 12^th June, 2014 at 9.30 a.m. Minutes: Resolved:- (1) That the next meeting of the Health Select Commission be held on Thursday, 12^th June, 2014, commencing at 9.30 a.m. (2) That a special meeting of the Health Select Commission be held on Thursday, 25^th June, 2014, commencing at 9.30 a.m.