Agenda and minutes

Apologies for absence were received from Councillor Allen.  Councillor Arculus was in attendance as substitute.

There were no declarations of interest or whipping declarations.

The minutes of the meeting held on 12 March 2013 were approved as an accurate record.

There were no requests for Call-in to consider

The purpose of this report was to provide the Commission with an update on the Trust’s current regulatory, strategic performance and financial position. Members were advised that a Contingency Planning Team (CPT) from Price Waterhouse Cooper (PwC) had been appointed by Monitor in December 2012 to review the operational, clinical and financial sustainability of the Peterborough and Stamford Hospital NHS Foundation Trust due to financial issues. It was stressed that the reason was not due to the quality of care. The areas the CPT were looking at were sustainability of the Trust; the PFI and options for the future. The report covered what had been found so far. Members were also advised that there was a more detailed public report available on Monitor’s website.

The review so far had found the Trust to be financially unsustainable but operationally and clinically sustainable. There had therefore been a lot of research looking at how to improve financial sustainability without reducing quality of care.   There was extra space in the building that was not currently being used and this was being looked at to see how it could be used as an option to improve the financial position.

The Board highlighted that they aim to focus on future care of patients and how this could be improved whilst becoming more efficient; rather than focus on the fact that there was a financial problem of which everyone was now aware.

Observations and questions were raised and discussed including:

·         David Whiles from Healthwatch Peterborough assured Members that they had been fully involved in the review process representing patients and had found the process to be very transparent and inclusive.

·         Members noted a concern was raised during presentations last year around boundaries with regard to Lincolnshire patients being admitted to the hospital. Members asked if this had been taken into account.  Members were advised that the Trust was subject to a national payment tariff for care to patients and was Payment by Results. The national menu was adjusted for local areas so that the price related to the area the care had taken place in. There was therefore a slight pricing difference between Lincolnshire and Cambridgeshire but the Trust had no influence over this. The Trust had been in a ‘block arrangement’ with Cambridgeshire and Lincolnshire but this year both of the areas were paying the same based on a national tariff basis.

·         Members were also concerned that all the work carried out for the review could be diverting hospital staff from achieving clinical deliverables. Members were advised that the Trust has tried to perform this process with minimal disruption to staff members. PwC had achieved this by using a range of different skills within the team who had the necessary knowledge to achieve this work which was similar to those skills and knowledge within the Trust. It was stressed that while this did take a bit of time now it was important for the future.  The potential benefits far outweighed any disruptions that may have  ...  view the full minutes text for item 5.

The Assistant Director Quality Information and Performance introduced the report which provided the Commission with an update on the delivery of Adult Social Care services in Peterborough against the key priorities identified in the department’s business plan, linked against the four outcome domains contained within the national Adult Social Care outcomes framework.  The report covered the fourth quarter of 2012-13 (January to March 2013).

It was acknowledged that the Commission was not content with the current format of the report and that a working group was being established in order to refine and improve the report. The major issues for Adult Social Care Services were highlighted including Safeguarding where a lot of focus was being placed in order to drive forward improvements in that area.

It was noted that information around home transfers had been provided as requested as well as a copy of the first Quality report which had been submitted to the Quality Board.

Observations and questions were raised and discussed including:

·         Members wanted to know what the key issues were regarding Safeguarding and when an action plan would be in place or full analysis completed. Members were advised that there were two key issues. One was around the process in terms of reporting which was the ability to evidence the speed and workflow for investigations. This was mostly due to the technical nature of recording and the fact that it was a new system being used and that some of the forms were cumbersome but were being reviewed. The second set of issues was around consistency and quality of practice. There was a substantial improvement plan being developed. Members were further advised that given the scale of transformation taking place within the department in order to ensure business as usual was adhered to a set of meetings had been put in place. The first scoping meeting had already been held and this would be followed by monthly meetings working on an action plan. The action plan would be worked on and ready to present every month until the beginning of next year at which point an external organisation would be brought in to conduct a Peer review of the practice.

·         Members referred to paragraph 5.2.1 of the report on page 21 which referred to the resettlement of permanent residents from Greenwood House and Welland House.  The report had stated that all residents had initial reviews carried out and that there would be a further review after six months.  The Commission had requested that quarterly reviews be carried out in the first year of resettlement and wanted to know why it had been changed to six monthly. Members were advised that the reviews that had taken place had indicated that it was safe to leave the reviews for six months. Members were further advised that the report did show that when the residents were being settled in it was felt that some of them would benefit from receiving weekly support. If the view was that the visits should  ...  view the full minutes text for item 6.

The report provided the Commission with an overview of Public Health responsibilities that had been transferred to the Local Authority and details of how those responsibilities would be delivered during 2013/14. It was noted that the key role of the interim Director of Public Health during the first six months was to ensure safe transfer of public health from the Primary Care Trust to PCC. Part of this work had been to produce a business plan that clearly outlined what Public Health was doing as well as a way of monitoring the facets of work being transferred.

It was noted that the business plan had unfortunately not been issued with the agenda and therefore any comments or questions should be forwarded to the Senior Governance Officer who would forward them to the Interim Director of Public Health.

A brief presentation of the business plan was given which included the following highlights:

• Public Health England Priorities
• Transformational change to improve health outcomes
• Role and Functions of Public Health
• Finance and resources
• Vision and Objectives for 2013/14

Members were informed how the Public Health staff and resources had been integrated into the Local Authority. The Public Health delivery team had been integrated within the Neighbourhoods team and other areas including Children’s Services. The Public Health directorate also shared a Health Care Specialist Advice service with Cambridgeshire County Council. The funds available to the Local Authority for the transfer of responsibilities was £8.446 million and Public Health reported quarterly on financial spend against these areas.

Observations and questions were raised and discussed including:

·         Members referred to page 5 of the business plan and asked about the phrase ‘good mental health’ and whether this should be ‘good mental health services’ instead. Members were informed that this was one of the priority areas within the Health and Wellbeing strategy and that was the heading. Under the heading there was a list of five objectives covering elements of service delivery. The word ‘services’ was not used because they were not only talking about improving services they were also talking about improving an individual’s mental health and well being.

·         Members referred to the Public Health outcomes and asked if there was a time frame for achieving these targets. Members were advised that the Public Health outcomes were targets for the current year.

·         Members asked for a report which would break down the targets and show deadlines throughout the year by quarter.

·         Members were concerned with the recent Public Health England statistics recently published showing Peterborough as 87^th on the list of Local Authorities.  Peterborough was also 14^th out of 15 on two of the measures. Members asked if these areas were being addressed. Members were advised that there was a close correlation between education achievement and these items and therefore this was probably not exclusively a Public Health matter. Members were further advised that the report showed nothing new and that the Public Health team was already aware of the statistics. Peterborough was doing very  ...  view the full minutes text for item 7.

The Senior Governance Officer introduced the report which provided the Commission with:

·         a review of work undertaken during 2012/13 and recommendations made

·         the terms of reference for the Commission and

·         a draft work programme for 2013/2014 for consideration

The Commission considered the report and decided that there were no recommendations from last year that required further monitoring.

·         Members requested that the ‘Carer’s Strategy’ to be added to the work programme. Members were advised that the ‘Carer’s Strategy’ was almost finished and was just having final touches added to the action plan.

·         Members asked about the follow-up presentation from the Ambulance Service regarding Ambulance support in taking patients home from the hospital. It was confirmed that the report was due to be submitted in January.

ACTION AGREED

The Commission requested that Carer’s Strategy be bought to the Commission as soon as it was ready.

The Commission received the latest version of the Council’s Notice of Intention to Take Key Decisions, 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 Notice of Intention to Take Key Decisions and, where appropriate, identify any relevant areas for inclusion in the Commissions work programme.

ACTION AGREED

The Commission noted the Notice of Intention to Take Key Decisions.

Tuesday 16 July 2013

The meeting began at 7.00pm and finished at 9.30pm