Agenda and minutes

Apologies for absence were received from Councillor Nash and Councillor Stokes.

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.

No declarations of interest were made.

The minutes of the meeting held on 13 September 2011 were approved as an accurate record.

Jessica Bawden, Director of Communications and Engagement at NHS Peterborough informed members that they may be aware that since the Commission had last met, the PCT had received notification of a complaint to the Competition and Cooperation Panel (CCP). The Panel recommended that no further decisions be taken on the primary and urgent care strategy consultation while the Panel was investigating the complaint. The Board considered this recommendation and decided that it would wait until the investigation was complete to consider the response to consultation. On Monday 14 November the PCT had been notified that the CCP wanted more time to consider the complaint and that it would proceed to its second phase. The CCP had up to four months to complete its investigation. Jessica Bawden suggested that she keep the Chair updated on progress and that the PCT return to the Committee when there was substantive business to discuss. The Chairman agreed and thanked Jessica for the update.

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 report provided the Commission with an update on the delivery of Adult Social Care services in Peterborough against the four outcome domains contained within the national Adult Social Care outcomes framework, and information on safeguarding adults at risk.  The Commission were also required to consider the draft Local Account for Adult Social Care.

The four outcomes were:

Outcome 1:  Promoting personalisation and enhancing quality of life for people with care and support needs.

Outcome 2:  Preventing deterioration, delaying dependency and supporting recovery.

Outcome 3:  Ensuring a positive experience of care and support.

Outcome 4:  Protecting from avoidable harm and caring in a safe environment

The Head of Performance and Informatics went through the Quarter 2 performance report highlighting areas for consideration.

Observations and questions were raised and discussed including:

·         Outcome 2 project for Learning Disability Intensive Community Support Team.   Members noted that the Intensive Support Team had identified 30 people who could return to Peterborough over the next three years and wanted to know where they currently were.  Members were informed that they had been placed out of area in residential placements around the country.

·         Outcome 3 national performance indicator for overall satisfaction with local adult social care services.  The report stated that 60.8% of those responding were either extremely or very satisfied with the service they received.  Members wanted to know if there was a follow up on the 40% who were not satisfied.  Members were advised that follow up was difficult as the survey was confidential.  However if there had been several negative comments from a particular care home then the care home would have been put under review.

·         Outcome 4 covered dated relating to safeguarding practice from October 2010 to and including September 2011. Members noted that there had been 266 alerts reported in the last 12 months and that in the last 6 months of that period the activity had doubled with 176 alerts compared to 90 alerts in the first 6 months.  Could the officers explain why?  The Director of Adult Social Services informed Members that the Safeguarding Board had discussed the data and concluded that the alerts and referrals had not yet settled into a consistent pattern either month on month or across the data in trends.  Therefore nothing could be concluded from the data as it did not seem to follow a particular pattern.

·         The Director of Adult Social Services informed Members that there was a lot of data around safeguarding but what the Safeguarding Board had wanted to focus on was the outcomes and could they be assured that people were being safeguarded and protected.

·         The Head of Performance and Informatics asked the Commission for their views on the draft Peterborough Adult Social Care Local Account.  Members commented:

o         It had been a good idea to include case studies.

o        That is was a readable report and the right length.

o        The way the statistics were presented would prove difficult for the general public to understand.  It might be better to  ...  view the full minutes text for item 5.

The Interim Chief Executive of the Peterborough and Stamford Hospitals NHS Foundation Trust introduced the report and informed the Commission that a presentation would be given covering:

·         An overview of the challenges

·         Safeguarding quality

·         Turnaround programme

·         Strategic development and progress

The Commission were informed that the Trust had been in significant breach of their Terms of Authorisation with the regulator Monitor.  The three areas that were in breach of the Terms of Authorisation all related to finance matters.  They were around the general duties to manage resources effectively and efficiently, financial governance and financial viability. The turnaround plan has been put in place to restore the financial stability to the organisation.

The overview highlighted the following:

·         Last year’s cost improvements of £5.1m  were delivered out of £9.3m plan

·         There was a National efficiency target of 4% for all trusts

·         Income had been reduced through commissioning year on year

·         Fantastic new facilities but with significant estates costs

·         Met all regulatory and statutory quality and other requirements

·         Having moved one year ago, the focus was to drive improvement in quality to deliver efficiencies and savings

·         Board imperative to maintain the quality of care for patients

·         Serious financial situation was being addressed

The Trust had a four year financial recovery plan in place and the focus was to drive quality improvement and safeguarding quality.  The financial situation was complex and there were several financial schemes in place to address the financial gap.  There was £7.1m of Quality, Innovation, Productivity and Prevention (QIPP) schemes in place reduced to include recurrent savings only.  The non-recurrent savings were captured separately.  £2.3m transitional funding had been received this year.

The Director of Care Quality and Chief Nurse informed the Commission that quality was the Trusts top priority whilst delivering financial savings through operational efficiencies.  There were three main areas to ensuring quality; patient safety, clinical effectiveness and patient experience. The challenge was to improve quality and achieve significant financial efficiencies by improving productivity, changing service delivery and continuous improvement.  The focus on the quality of patient care would be retained through various measures including:

·         Monthly monitoring of patient safety, clinical effectiveness and patient experience indicators

·         Quality Impact Assessments (QIAs) for all schemes put forward as part of the turnaround programme

·         Patient safety walkabouts

·         Roles of Medical Director and Director of Care Quality and Chief Nurse

·         Staff able to raise any concerns on safeguarding quality of care

·         Additional safeguards through independent regulation

·         Review of adverse event monitoring

·         Issues raised through adverse event reporting, complaints, Patient

·         Advice and Liaison Service and Local Involvement Networks

The Turnaround programme consisted of four main areas:

1.      Internal Controls – Cash and expenditure controls to stabilise the situation

• Quality and Financial Recovery Groups (QFRGs)
• Strengthened risk based approach to safeguard quality

2.      Operational Efficiency – Optimising performance of existing services and facilities

• Capacity management
• Non-pay, Service line reviews

3.      Estate Costs – reducing estate costs to support financial viability

• Reduce estate costs to an affordable level

4.      Strategic Development  ...  view the full minutes text for item 6.

The Commission 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 Commission noted the Forward Plan

Members considered the Committee’s Work Programme for 2011/12 and discussed possible items for inclusion.

ACTION AGREED

To confirm the work programme for 2011/12 and the Scrutiny Officer to include any additional items as requested during the meeting.

Denise Radley the Director for Adult Social Services  was due to commence maternity leave in December and the Chair on behalf of the Commission wished her good luck and thanked her for her support to the Commission over the past year.

Thursday 5 January 2012

Joint meeting of Scrutiny Committees and Commissions to scrutinise the Budget 2011/12 and Medium Financial Strategy to 2015/16

Tuesday 17 January 2012

Scrutiny Commission for Health Issues

17 January 2012