Agenda and minutes

No apologies for absence were received.

Apologies were received from Jane Pigg, Peterborough and Stamford Hospitals NHS Foundation Trust.

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.

Agenda Item 5

Councillor Rush declared a personal interest in that he had a family member residing in a care home in Peterborough.  Councillor Rush advised that he would step down from the Chairs role for this item and Councillor Lamb would take the Chair.

Agenda Item 6

Councillor Sharp declared a personal interest in this item.

Councillor Sharp highlighted that the minutes had recorded that the meeting had been held in the Bourges and Viersen rooms at the Town Hall when in fact it had been held at the Peterborough City Hospital.  The Senior Governance Officer noted the mistake. The minutes of the meeting held on 15 November 2011 were then 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.

Councillor Lamb took the Chair for this item on the agenda.

The Assistant Director of Social Care introduced the report and wished to note that there was a typographical error on page 9, paragraph 4.5.  The number of residential placements should have read 475 not 445.

The report informed the Commission on the quality of care homes covering how the care homes were monitored and how well they were doing.  In Peterborough, there were 20 care homes which had beds for older people. Two of the care homes were provided in-house and the rest were from the independent sector. Some provided care for younger adults too, and in addition there were other care homes providing care just for younger people and people with a learning disability. A recent survey conducted by the Review and Monitoring Team (November 2011) found that there were 772 places for older people in the independent homes of which 79 were vacant.  There were also 70 places at the two in house homes.

The Compliance Manager for the Care Quality Commission (CQC) informed the Commission on how the CQC regulated services. Care homes were regulated by the (CQC) and reviewed and monitored by the Contract Reviewing and Monitoring Team in NHSP.

CQC was the independent regulator of all health and social care services in England. Its job was to make sure that care provided by hospitals, dentists, ambulances, care homes, in people’s own homes and elsewhere met government standards of quality and safety. The government standards covered all aspects of care, including:

·               Treating people with dignity and respect

·               Making sure food and drink meets people’s needs

·               Making sure that that the environment was clean and safe

·               Managing and staffing services

Observations and questions were raised and discussed including:

·         Peterborough LINk had worked closely with the CQC and had carried out five inspections.  Reports from the inspections were passed onto CQC and actions on any issues were now being addressed.  This proved that a multi agency approach did work.

·         How often did unannounced visits to care homes take place?  Members were informed that it varied and was dependant upon the risk.  There was no prescribed frequency.  Those not complying with the law had more frequent visits. 

·         If a member of the public wanted to contact CQC how could they.  There were a few ways.  Via the website, telephone, through the inspectors, information was also collected from members of the public, through PALS and through Councillors.

·         Do you use family and friends of patients to get information?  Was the service advertised in the care homes with contact details so that people could advise you of complaints and compliments.  Members were informed that every effort was made to ensure the service was advertised.  Complaints and compliments were received via the services and services were checked to see what they did with the complaints.  Most services were compliant.  When visiting the care homes every opportunity was taken to talk to family members to obtain feed back on the service  ...  view the full minutes text for item 5.

The Interim Chief Operating Officer presented the report which informed the Commission on the context, scope and progress of the NHS Peterborough Quality, Innovation, Productivity and Prevention (QIPP) and Reform Plan.

The delivery of the transformation covered under the QIPP work underway in Peterborough was of a significant scale and involved complex and inter-related issues. Oversight of the delivery of the plan was dealt with locally by the Health and Care Transformation Board comprised of the Chief Executives of the main commissioning and providing organisations, including Peterborough City Council.

The plan dealt with both the required improvements for the commissioners and providers and had identified new ways of working that would:

·         Deliver a better patient experience

·         Improve people's health

·         Reduce unfairness in health.

Work was currently underway to refresh the plan for 2012/13.

Observations and questions were raised and discussed including:

·         How does the £2305 spend on health care per person on average compare to that spent on health care per person in Cambridge?  Members were informed that the figure had been arrived at by taking the total budget figure and dividing it by the number of patients.  The officer advised that he did not know the Cambridge figure for spend on health care per patient but could find out and report back.

·         The Chair of LINk commented that the report should also reflect national spend on health care per patient.

·         The QIPP and Reform Plan document has a section at the end titled ‘How will I find out what is happening?’ and gave a website address.  How will people who do not have access to websites find out what is happening.  Members were informed that any major changes and consultations would also be published via the GP surgeries and in the media. At the back of the document there were also contact details for PALS via telephone, email and an address to write to.

·         Have the patient forums in doctors surgeries received the QIPP and Reform Plan.  The Joint Director of Communications and Patient Experience felt sure that they had gone out to GP Surgeries in November but would check.

·         Ensuring quality.  The QIPP plan states; ‘Bed utilisation – improving systems to maximise bed usage and ensure patients get the right care in the right place’.  After Christmas it had been reported in the newspaper that 69 operations had been cancelled.  Can you assure the Commission that this was just a ‘blip’?   Members were informed that the intent behind the statement in the plan was to ensure people were seen in the right place at the right time.  There would be issues that occurred from time to time and particularly during the winter.

·         After some discussion around the figures within the QIPP Plan Members and Officers noted that there had been a misprint of the document during publication and some of the figures had not been printed correctly.  The published version on the Peterborough City Council website had been correct but in the printed version some figures had not  ...  view the full minutes text for item 6.

The report informed the Commission on the developing clinical commissioning in Cambridgeshire and Peterborough.  The project had been running for two years and there was another eighteen months to go. The new Bill had yet to pass through the final stages of Parliament. The main changes that would affect Peterborough were centred on the establishment of new Clinical Commissioning Groups (CCGs) by 2013 and the establishment of a Health and Wellbeing Board.  The CCGs would be based on groupings of GP practices, clinically led.  The Health and Wellbeing Boards would be the key vehicle for joint working and agreeing a Health and Well-Being Strategy.  There would also be an establishment of a new NHS Commissioning Board in October 2012 and public health functions would be transferring to local government.  Local proposals were:

•          One Clinical Commissioning Group for Cambridgeshire and Peterborough

•          The CCG would be made up of a federation of a number of (8) Local Commissioning Groups (LCG)

•          There would remain a strong focus on Peterborough and the needs of its residents

•          LCGs would be enabled and supported by the CCG to make local change happen and manage resources through delegated budgets

•          LCGs would be able to take on different responsibilities and operate at different speeds

•          The CCG Governing Body would ensure that statutory duties were met, hold LCGs to account, and ensure probity

•          All of the above was subject to authorisation by the NHS Commissioning Board in autumn 2012

Observations and questions were raised and discussed including:

·         The current spend per patient is £2305 per person per annum.  Will the CCG’s split the budget equality amongst all the patients or will Peterborough get an increased share because of the complexities of the demographics.  Members were informed that there had been no further information on this.  Peterborough did have demographic issues and practice population calculations generate the notional practice budget which did have a definite link to demographics.  The rules and regulations changed every year and up to recently there had been a heavy waiting applied for deprivation but this had now been removed.  It was population based computation and was based on the age and morbidity of the population.  If a practice had a higher population of elderly patients it would have a higher budget.

·         Will these changes be good for Peterborough and fit Peterborough’s needs?  The answer was two fold.  The old system was only delivering in patches and had not been sensitive to patients needs.  The changes had offered an opportunity to keep an eye on quality while trying to deliver better health in partnership with the public.

ACTION AGREED

The Commission requested that a further report on progress be brought back in July.

            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.

The Chair asked the Director of Communications and Engagement at NHS Peterborough for an update on the complaint to the Competition and Cooperation Panel (CCP).  Members were informed that it was expected that they would publish an interim report in one weeks time which would suggest alternative remedies for the complaint.  There would then be a two week consultation process whereby interested parties could comment on the suggested remedies. The final report would then be published during the first week of February with the final remedy.

Tuesday, 13 March 2012

13 March 2012