Agenda and minutes

Apologies had been received from Councillors Lowndes, Arculus, and Fower and Councillors Peach and Sandford were in attendance as substitutes.  Apologies had also been received from Diana Millard, LINk representative.

At this point Members must declare whether they have an interest, whether personal or prejudicial, in any of the items on the agenda. Members must also declare if they are subject to their party group whip in relation to any items under consideration.

There were no declarations of interest.

To approve the minutes of the meeting held on 14 June 2010.

The minutes of the meeting held on 14 June 2010 were approved as an accurate record.

The decision notice for each decision will bear the date on which it is published and will specify that the decision may then be implemented on the expiry of 3 working days after the publication of the decision (not including the date of publication), unless a request for call-in of the decision is received from any two Members of a Scrutiny Committee or Scrutiny Commissions..  If a request for call-in of a decision is received, implementation of the decision remains suspended for consideration by the relevant Scrutiny Committee or Commission.

There were no requests for Call-in to consider.

The Scrutiny Officer reported to the Commission on the proposed protocol and working arrangements between the Scrutiny Commission for Health Issues and the Peterborough Local Involvement Network (LINk). The Protocol set out an agreed process for dealing with referrals between the Peterborough LINk and the Scrutiny Commission, and clearly set out each body’s commitment to working together to promote the general health and wellbeing of the residents of Peterborough.  The draft protocol had been considered by the LINk and had been approved.  The Commission were asked to consider the protocol and formally approve the agreement.

Councillor Khan requested confirmation of the Commissions terms of reference with regard to Call-In requests and decisions made by the PCT. The Scrutiny Officer advised that the Commission had the right to call-In decisions made by the Executive of the Council but not to call-in decisions made by the PCT.

The Commission approved the draft Protocol.

ACTION AGREED

That the Commission approve the draft Protocol.

The Executive Director of Adult Social Services presented the report in the absence of the Interim Director of Finance of the Primary Care Trust (PCT).  The report provided the Commission with the 2009/2010 audited financial outturn of the PCT.  The bottom line figure showed an overspend of £12.832M in 2009/10 and how this occurred.  The Executive Director of Adult Social Services advised that the PCT had a turnaround plan in place and this sought to make around £24M savings in this year.

Observations and questions were raised and discussed including:

·         Members noted that the Corporate Services and Management structure budget figure was £13M but the actual figure was £14.5M.   How did this compare with the administration costs of other Primary Care Trusts in this part of the country and how much of that figure was involved with employing external consultants – not medical consultants.  Members were advised that the £14M was not all staff costs and some was for the running costs of premises. Peterborough's costs are high although it is difficult to compare as the PCT covers adult social care as well, which other PCTs do not.  A strong focus of the turnaround plan was to look at reducing management costs. No information was available at the meeting on costs of consultants but the officer offered to provide this at a later date.

·         Members wanted to know why the PCT had under spent against capital resources.     Members were advised that capital funds had to be bid for 4 or 5 months before the start of the financial year.  At that time it was anticipated that they would develop a permanent infrastructure for primary care.   Plans had changed and the full amount was not now required.

·         How would the new government’s initiatives affect the PCT?  Members were informed that a white paper on the National Health Service had been published within the last week and it outlined significant changes to services.  There were still a number of detailed documents to be received giving the detail of these changes.  The Commission would receive a report on this at its September meeting. 

·         Why was the budget overspend not being monitored through 2009/2010 and appropriate action taken?  The Commission were advised that there were a number of factors for the overspend, one being the budget setting process.  There was reporting to the PCT Board and other bodies but some of the concerns were not spotted early enough and plans to mitigate those issues did not have an impact early enough.  Governance was now more robust and a Finance and Performance Committee had been set up.    It was being taken extremely seriously and was being monitored very closely. The Board met monthly and the reports were published on the website for public viewing.

·         Members confirmed the continued need to receive very regular reports on the turnaround plan and to be kept informed of any changes as early as possible.  The Commission would receive a further update in November. 

ACTION AGREED

(i  ...  view the full minutes text for item 6.

The Executive Director of Adult Social Services presented the regular quarterly report on work regarding Safeguarding of Adults.  Since the last report there had been improvement and changes to data recording.  National reporting requirements had changed and it was now reported from a single client data base which allowed reporting on more areas.  There was now more information on outcomes and better quality of information.  Allegations were now either categorised as substantiated, not substantiated or partly substantiated and cases were closed on that basis.  Further work was required to investigate some cases that were taking longer than expected to close.  The average levels of referrals were 22 to 25 a month for Peterborough with the highest proportion of referrals coming under the physical disability or frailty category as it covered all age groups.  The Adult Safeguarding Board which oversees the action plan agreed at its meeting in April that the action plan would be refreshed and separated out into an improvement plan and a further work programme.

Questions and observations raised by Members

·         Were there any checks in place to make sure vulnerable people were getting all the information they needed.  Members were informed that there was a lot of work happening around increasing awareness in these groups and additional work around raising public awareness.

·         Were people who needed safeguarding services fully involved in and in control of the safeguarding processes?   Members were advised that on an individual basis people were fully involved in the decision making processes around the services they received; however more work needed to be done by the Safeguarding Board as it was a sensitive topic. A face to face interview survey had taken place but this had produced limited responses however the results were being used to improve services.  A carer had also been invited to join the Board to bring in their views.

·         Did the Board have the resources to deliver the improvement plan?  Members were advised that the Council had invested an additional £1/2million into adult safeguarding work to provide the necessary level of investment.  One of the key areas that the money had been used for was to put in place a completely redesigned team.  Job adverts were about to go out for highly specialised roles which required extensive experience in this area.  The Safeguarding Board also had excellent partner engagement and sign up to the Board across a wide range of organisations.

·         Did all the staff still receive the appropriate training?  Members were advised that all staff received appropriate training and that a programme was agreed every year by the Board and was adjusted to changing legislation and needs.  There was basic awareness training for everyone which Members could also receive.

ACTION AGREED

The Committee noted the report.

To receive a report from NHS Peterborough on the future delivery of walk-in services in Peterborough.

The Director for Strategic Change for NHS Peterborough introduced a report informing the Commission of NHS Peterborough’s proposed consultation on the future provision of services at the Alma Road surgery with the PCT’s recommended option being to close the service. A review of all services had been undertaken and in particular urgent care services and the walk-in centre which had opened in Alma Road in April 2009 was part of these services.  The conclusion had been reached to close the Alma Road service based primarily on the fact that there were duplicative and similar services close by. Services for patients and choice for patients would be maintained whilst closing Alma Road. Alma Road offered services to registered patients for primary care and a walk-in service for registered and unregistered patients.  There were currently 11 other GP practices within one mile of Alma Road who offered registered services in the area, 10 of which had open lists and offered extended hours but not from 7.00am to 10.00pm.  The City Care walk-in service, which was nurse led, offered a similar service and was just over one mile away from Alma Road.  There would be a consultation period of 8 weeks and 2 public consultation meetings during August.

The Director for Strategic Change had been advised by the providers of the services at Alma Road prior to the meeting that there were more up to date statistics available since the report had been written.  The current figures showed an increase in registered patients since April 2010 from 400 to 610 on 12 July. The current monthly rate of attendance at the walk in centre was closer to 500 per week than the stated figure.  The consultation paper would be amended to reflect this new information.

Questions and observations raised by Members

·         Local ward councillors advised that they had not been informed on the proposal.

·         Alma Road was opened in April 2009 and was gaining patients daily.  If the target of 2000 patients was to be reached would the consultation be stopped and no further action taken. The area in which the practice sits was an area of growing population.

·         If this was a genuine consultation why had the doctors been given notice to close before the consultation had started?

·         At a recent event at the Town Hall where several GP practices were represented including the Alma Road practice, they were offering services to people who were currently registered with the Sergeant Street surgery which was due to close.  Why was Alma Road Surgery represented at this event when it was being considered for closure?

·         Even though the Alma Road practice was only set up 18 months ago the report indicated that there was over provision in the area.  Why therefore did ward Councillors receive complaints from people saying that they found it hard to get appointments and had to wait so long at their own doctor’s surgery?

·         Members felt that in general the financial management and strategic direction of the PCT  ...  view the full minutes text for item 8.

The Committee received the latest version of the Council’s Forward Plan, containing key decisions that the Leader of the Council anticipated the Cabinet or individual Cabinet Members would make during the course of the following four months.  Members were invited to comment on the Plan and, where appropriate, identify any relevant areas for inclusion in the Committee’s work programme.

ACTION AGREED

The Committee noted the Forward Plan and agreed that there were no items to bring to the Committee.

Members considered the Commissions Work Programme for 2010/2011 and discussed possible items for inclusion.

ACTION AGREED

To confirm the work programme for 2010/11.

The next meeting of the Scrutiny Commission for Health Issues is scheduled to be held on Monday, 13 September 2010.

Monday 13 September 2010 at 7pm