Agenda and minutes

Apologies for absence were received from Councillors Arculus and Nash.  Councillor Dobbs was acting as the designated substitute and Councillor Peach as a nominated substitute. 

Apologies for absence were also received from Councillor Lamb, Cabinet Member for Health and Adult Social Care and Gill Metcalfe of the Peterborough LINk.

There were no declarations of interest.

The minutes of the meeting held on 13 September 2010 were approved as an accurate record.

There were no requests for call-in to consider.

The Commission considered the response made by NHS Peterborough to the recommendation made in relation to the provision of contraceptive and sexual health services for young people.

ACTION AGREED

To note the response to the recommendation and that a further report on the issue will be brought to the Commission in January 2011

The report gave an update on the progress being made on the Teenage Pregnancy Strategy to reduce teenage conceptions in Peterborough.  In 2007 the then Health and Adult Social Care Scrutiny Panel undertook a review of teenage pregnancy services in Peterborough and had followed the progress of the issue at subsequent meetings. This report updated the Commission on the progress made since its last report on 31 March 2009.

Peterborough was facing a challenge in reducing the number of teenage pregnancies.  The national teenage pregnancy target was a 55% reduction in teenage pregnancies by 2010 from the 1998 baseline of 57.7 conceptions per 1,000 15-17 female population in Peterborough.  This was a challenging target and one which was unlikely to be met locally or nationally.   The latest data from the Office of National Statistics showed Peterborough’s rate of teenage pregnancies continued to fluctuate. The rolling quarterly average rate from January to March 2009 was 56.3 conceptions per 1,000 of the 15-17 female population. This was higher than national, regional and statistical neighbour averages.  Within the same period, the rate of teenage pregnancies leading to abortion was slightly higher than national and regional averages and broadly in line with our statistical neighbours. In terms of numbers, this equated to 94 conceptions of which 38 led to abortion between January and March 2009.

The National Teenage Pregnancy Strategy would draw to a close in 2010, although the issue of teenage pregnancy remained. The Strategy was intended to develop services to prevent teenage pregnancy and support existing teenage parents with the aim of those services being mainstreamed by 2010.

In line with the Scrutiny Panel recommendations, national guidance and the recommendations from Peterborough’s National Support Team visit the following key areas had been focused on during the last year:-

• Ensuring focus was on the prevention of teenage pregnancies
• Improving sex and relationship education (SRE)
• Providing a full range of contraception and ensuring contraceptive and sexual health (CaSH) services were young people friendly and accessible
• Working jointly wherever possible
• Linking teenage pregnancy with other risk taking behaviour
• Using local data to target services at the most at risk
• Engaging young people in service delivery and planning

Examples of the progress achieved during the last year included:

Case Study 1: Targeting SRE to the most vulnerable and at risk

Local data provided by Children’s Services was used to help identify young people at risk of not meeting their potential.  These young people were invited to take part in a self esteem based programme run by youth workers.  The programme discussed sexual health issues and its links to drugs, alcohol and risky behaviour amongst other things.  It aimed to equip young people with increased self esteem, knowledge, confidence and social skills to make informed choices about their behaviour.  The programme was in its second year and had received positive feedback from young people and staff.

Case Study 2: Helping parents discuss sex and relationships with their children - Speakeasy Programme

The accredited Speakeasy  ...  view the full minutes text for item 6.

We welcomed John Webster, Director of Turnaround at NHS Peterborough to the meeting who gave an update on the delivery of the Turnaround Plan.

The target for the year was to achieve savings of £23.75m and to date £7.8m savings had been made however there was a predicted shortfall of £1.6m.   

Questions and observations were made around the following areas:

• How much confidence did Mr Webster have that the right calibre of management was in place that could turn the situation around?  Paul Zollinger-Read had already had an impact across Peterborough and Cambridgeshire.  There were committed people in NHS Peterborough but continuity of leadership was now needed.  There was a commitment within the organisation to make schemes deliver.
• Was there confidence that the targets would be met?  There was confidence in people’s skills and further work would be undertaken to look at some of the projects in detail.  There continued to be some pressures in areas such as acute care.
• An article had been in the Sunday Times on how some PFI hospitals were coming under pressure due to the high costs for general maintenance.  How could this affect Peterborough in the future?  There were lessons to be learnt through earlier PFI schemes and we needed to understand the costs going forward.  The new hospital would bring efficiencies to services.
• Community and mental health were both showing as amber, how would that become green?  The RAG status was comparing performance not money.  For example investing in rehabilitation and reablement services, if done well, would lead to savings in the future as well as better performance.
• Mary Cooke asked why corporate and back office was showing that there were no issues to report.  The new GP Consortia would need to be trained and supported which would mean that there would be a cost in getting them organised.  The majority of savings within corporate was down to staff leaving NHS Peterborough.  A reduction in bureaucracy was expected but it would be difficult to balance.

ACTION AGREED

To note the current position of the NHS Peterborough Turnaround Plan and to receive a further update in March 2011.

The report provided an update on the Safe Sharps Disposal Pilot.

The Safe Sharps Disposal Pilot placed special bins for injecting equipment and other sharp implements in public places to reduce the risk of injury and potential transmission of blood borne viruses to members of the public.  In November 2009, the Commission were advised that a project implementation plan had been drawn up for the installation of the bins and the bins had now been installed in seven locations around the city between January and March 2010.  One of the bins had to be removed due to it being wrongly sited on private land and work was now underway to identify an appropriate site for this to be moved to.

The bin locations had been promoted via the service specific and pharmacy needle exchanges in the city to all drug users, and had been clearly labelled with the needle exchange logo so that those who used injecting equipment were aware of what they were for.

Last week 171 needles had been collected from the bins and this could be partly related to work which had been done to secure a number of properties where needles were being used and also to the hard work the local services and service user groups had been undertaking to promote use of the bins.  In addition, the incidents of reported discarded needles and drug-related litter around the city had dropped slightly from 170 to 122.  However the use of the bins had not been as high as quickly as was originally hoped.

The low use of the bins might be due to a number of factors, including:

-          hotspots having moved;

-          greater numbers of needles being returned to needle exchanges and an increase in the portable sharps bins given out;

-          fear of using the bins;

or a combination of all three.

Feedback was that users were willing to use the bins and word was starting to get around. Officers were currently undertaking work to identify how the bins could be better promoted. 

Questions and observations were made around the following areas:

• Were there any leaflets in the Centre’s which showed where the bins were?  No leaflets were produced but information was available in pharmacies.  The needle exchange logo was also on the bins.
• It would be useful to see a comparison of the number of needles collected in the bins compared to the number of needles that City Services collected.  More comparative data could be supplied.  We would also keep an eye on hotspots to see if the bins needed to be moved to other locations in the future.
• Were the bins able to be used by diabetics?  Yes, potentially they could and it was thought that diabetics would recognise the needle exchange logo.
• Perhaps the focus of the bins needed to change and could be promoted as an additional service to diabetics.  This would need to be discussed with health colleagues.

ACTION AGREED

To note the progress of the Safe Sharps  ...  view the full minutes text for item 8.

The report detailed progress against adult social care key outcomes and targets for the year 2010-11.

The new national performance framework for adult social care identified the following three outcomes for focus:

·         Health and wellbeing

·         Choice and control

·         Dignity and respect

There was now much less focus on National Indicator sets to judge performance and the new report format was more evidence based.

Health and Well Being

The team at 17 Fletton Avenue had secured sponsorship from John Lewis and also the Italian Community Association to develop a group for learning disabled people to have a kick about in the local park.  This group had now become a competitive side who now entered competitions and had won trophies.  Meetings had taken place with the Football Association (FA) and it was hoped that formal entry into a league would happen as part of the five year plan for disability football that the FA had.  Service users participating in this scheme had shown improved communication skills, motivation and self-confidence.

Choice and Control

• The data for October had now shown that over 30% (national target) of service users now had a personal budget.
• The indicators for adults in contact with mental health services in settled accommodation and in paid employment were both showing as red.  There were some data issues but there were also some issues around employment.

Dignity and Respect

The Peterborough Palliative Care in Dementia Group had won the NHS Team of the Year 2010, chosen by the Dementia Services Development Centre of the University of Stirling.  The group had been founded in 2005 by a Consultant in Palliative Medicine and a local GP after a shared experience looking after a care home resident dying with advanced dementia.  The group aimed to develop and disseminate good practice in care of people with dementia at the end of life, with a particular focus on nursing / residential homes, but also in hospitals and community settings.

The results of an audit of 12 months of hospital admissions from 6 local care homes showed a 40% reduction in admissions and a 45% reduction in deaths in hospital from this population, the majority of who had dementia, three years after the establishment of this group.

Questions and observations were made around the following areas:

• What were the issues around the performance of mental health?  There were issues around data particularly as we were not certain of how many people there were or how many were not in employment.  There were also issues around how we supported people in employment.  Around employment there had been a small amount of additional funding this year but there needed to be a review of how the money had been used as we had not seen an impact on the indicator.  With the housing indicator there were issues with ensuring the right type of housing was available and there was a lot we could learn from our work with people with learning disabilities.
• Were social housing providers required to  ...  view the full minutes text for item 9.

The report provided an update on the latest performance on adult safeguarding.

The key points were:

• The average number of referrals was 31 a month, which was down slightly on last year.
• More females were the alleged victims of abuse.
• Most allegations of abuse happened in the victims own home.
• Older people/physical frailty was the biggest vulnerable group.
• The dementia figures looked low, which was an under reporting issuing which had been identified.
• Adverts were now going out for the new safeguarding team.
• An independent chair of the Safeguarding Board was being recruited.
• The Safeguarding Policy was being reviewed.

ACTION AGREED

(i)                  To note the latest performance on adult safeguarding.

(ii)                That a copy of the Safeguarding Policy be circulated to Commission members once it has been reviewed.

The latest version of the Forward Plan, showing details of the key decisions that the Leader of the Council believed the Cabinet or individual Cabinet Members would be making over the next four months, was received.

Questions and observations were asked around the following areas:

• Future of Peterborough Community Services – Executive Director to circulate details of the proposed decision.
• Drug and Alcohol Misuse Services for Children and Young People – Scrutiny Manager to get an update on the decision.

ACTION AGREED

To note the latest version of the Forward Plan.

We considered the Work Programme for 2010/11.

It was agreed to add the future of Orton Medical Practice to the work programme for January 2011.

ACTION AGREED

To confirm the work programme for 2010/11.

Monday 17 January 2011 at 7pm

Monday 17 January 2011 at 7pm