Minutes:
Joint Health and Overview Select Committee
The Chairman reported that he had attended a meeting on 28th November, 2014. There were major concerns from the attendees, some of which had been involved from the beginning, around the failure of NHS England to consult until the standards for Coronary Heart Disease had been accepted. They had been told that until the conditions were accepted, there would be no serious debate or consultation. This was creating a great deal of frustration.
They were also conscious that they had 4 surgeons at Leeds but not the workloads. It was a balance of retaining 4 surgeons/workload against a succession plan given the speciality/experience of the surgeons.
Information Packs
It was noted that a separate pack had been produced containing items for information. Should any Member have any issues to raise on the items contained therein they should be raised under Communications.
Access to GPs Review
The Overview and Scrutiny Management Board had requested a special Health Select Commission meeting to discuss the response due to a lack of detail with how some of the recommendations would be actioned even though they had been accepted.
A special meeting had been arranged on 15th January, 2015, at 9.30 a.m. to which the Clinical Quality Commission, Clinical Commissioning Group and NHS England had been invited.
Meeting with Rotherham Foundation Trust
The last meeting had been held on 24th November the notes of which were not available as yet. At the January meeting the Trust would give an update on both their action plan and the Quality Account. They were applying to Monitor for the enforcement regarding governance to be lifted.
Seminar
A seminar was to be held on 9th December at 9.00 a.m. on the Care Act.
It was noted that Speak-Up had produced an easy read booklet on the Act.
Care Home Pilot – Waste Medicine Management
Discussions had taken place with Shona McFarlane, Director of Health and Wellbeing.
Medication in care homes was a complex matter delivered in partnership between the resident, their GP, the pharmacist and the care home. Most care homes operated a monitored dosage system or systems determined by the operating company many of which were national organisations. In setting up a contract, the Council required the home to operate a safe system of ensuring that residents received their medication correctly but the Council could not determine which specific system was used.
The key issue when delivering medication in residential care was safety and most homes found that a monitored dosage system resulted in a reduction in errors. The safety of the systems was not matched by flexibility and should someone not take their medication, or prescription change, the pre-filled cartridges were returned to the pharmacist to be destroyed which could result in wastage.
There were times when the prescription was completed incorrectly or the pharmacist did not complete the order correctly which could also result in waste when the homes had to send back the medication.
The in-house service operated 2 different approaches. Both were monitored dosages but for the home where there was 1 GP only, they had to be able to enter into an agreement to run an electronic version which resulted in a simpler to use system which could reduce waste. The Rotherham Clinical Commissioning Group was hoping to move to a ‘1 care home 1 GP’ system which should enable more homes to use the approach.
Minor Oral procedures
At the last meeting it was agreed that the Chairman would write to NHS England with regard to the issues raised by Members about the proposals.
1 Whether the proposals would have a significant detrimental impact on Rotherham Hospital.
NHS England had engaged with the Foundation Trust about the proposals and did not consider that there would be a significant detrimental impact on the hospital. The number of patients who would be treated by an oral surgery specialist in the community represented a small proportion of the total number of patients treated in the Trust’s Oral and Maxillofacial Department. The Foundation Trust would continue to play a major and vital role in the provision of oral surgery procedures but would have a greater proportion of complex cases to manage.
2 It is essential that the contract is awarded to a practice that is easily accessible by public transport.
Accessibility of the service was a primary consideration and this was assessed through the tender evaluation framework developed for the procurement. Bidders were required to include within their premises proposal a description of the public transport services serving the particular location.
3 It is also important that the successful practice is fully accessible for disabled people in terms of both physical access and information about their treatment.
The premises proposed by any potential provider would be assessed to ensure appropriate access for patients with disabilities. However, minor oral procedures would still be available at the hospital and this may be the most appropriate place for some patients. Some patient groups received their regular dental care from the Community Dental Service based at the Community Health Centre and they would also be likely to receive oral surgery treatment at the hospital. The patient clinical pathway took account of patients’ other health conditions when deciding on provider and location for treatment.
4 If information is available about the number and location of dental practices who already offer such procedures without needing to refer patients to the hospital.
At present no dental practices in Rotherham held a contract with NHS England to provide the services.
5 What arrangements will be in place for ongoing monitoring of service quality in the new contract?
All NHS England dental providers were monitored to ensure a high quality service was provided. Qualified dentists were employed as dental advisers to the commissioning and contract management team and they had a key role in monitoring service quality, mainly through practice inspections and record card audits. Providers also had to carry out patient satisfaction surveys, annual audits and to implement systems that supported the provision of a quality service.
Resolved:- That the Commission’s satisfaction with the response to the issues raised be noted and the proposals be supported.