Agenda and draft minutes

Venue: Bromley Civic Centre

Contact: Kerry Nicholls  020 8313 4602

Items
No. Item

1.

APOLOGIES FOR ABSENCE AND NOTIFICATION OF SUBSTITUTE MEMBERS

Minutes:

Apologies for absence were received from Councillor Ian Dunn, Councillor Judi Ellis, Councillor David Jefferys, Lynn Sellwood and Justine Godbeer.

 

Apologies for absence were also received from Tim Spilsbury, and Stephanie Wood attended as his substitute.

 

Apologies for lateness were received from Councillor Aisha Cuthbert.

2.

DECLARATIONS OF INTEREST

Minutes:

Councillor Mary Cooke declared that she was a former employee of Bromley Healthcare and had left the organisation in 2012.

 

Councillor Yvonne Bear declared that she was a member of the Council of Governors for Oxleas NHS Foundation Trust representing the Local Authority.

3.

QUESTIONS FROM COUNCILLORS AND MEMBERS OF THE PUBLIC ATTENDING THE MEETING

In accordance with the Council’s Constitution, questions to this Committee must be received in writing 4 working days before the date of the meeting.  Therefore please ensure questions are received by the Democratic Services Team by 5pm on Thursday 5th July 2018.

Minutes:

No questions had been received.

4.

MINUTES OF THE MEETING OF HEALTH SCRUTINY SUB-COMMITTEE HELD ON 6TH MARCH 2018 AND MATTERS ARISING pdf icon PDF 110 KB

Minutes:

RESOLVED that the minutes of the meeting held on 6th March 2018 be agreed.

5.

REABLEMENT WORKSTREAM WITHIN BROMLEY ADULT AND OLDER PEOPLE'S MENTAL HEALTH DIRECTORATE (OXLEAS NHS FOUNDATION TRUST)

Minutes:

The Sub-Committee received a presentation from Estelle Frost, Service Director, Bromley Adult Mental Health Services, Adrian Dorney, Associate Director, Inpatient and Crisis Services, Donvé Thompson-Boy, Lead Occupational Therapist and Pauline Kenny, Mental Health Service Manager, Oxleas NHS Foundation Trust on the Reablement workstream within Bromley Adult and Older People’s Mental Health Directorate.  Councillor Yvonne Bear, a member of the Council of Governors for Oxleas NHS Foundation Trust representing the Local Authority was also in attendance.

 

The Reablement workstream had been developed after it was identified that there was a lack of reablement support available to patients with mental health needs admitted to hospital for physical health issues following their discharge.  This included the establishment of a Pathway which supported partners to work collaboratively in completing a rigorous assessment of needs and a discharge planning process for each patient, and also offered increased availability to Reablement and Transfer of Care Bureau resources.  Further work being undertaken in this area included a review of access to Extra Care Housing, mental health awareness training for domiciliary care workers, and joint Transfer of Care Bureau and Oxleas NHS Foundation Trust briefings to promote cross-working and improve access to care.

 

In considering the Reablement workstream, the Chairman was pleased to note that patients’ needs were being treated more holistically.  The Vice-Chairman underlined that this should include the physical, mental and social care needs of patients with mental health needs who had been discharged from hospital.  The Associate Director, Inpatient and Crisis Services reported that key partners were working increasingly closer together to ensure that comprehensive packages of care were in place to meet the individual needs of people with mental health needs.  The Interim Director: Programmes noted that the Local Authority and Bromley Clinical Commissioning Group were also working together to develop integrated strategies on ‘Ageing Well’ and ‘Adult Mental Health’ that would identify the longer term vision for these key areas of service provision.  A report on the Adult Mental Health Strategy would be presented to Health Scrutiny Sub-Committee at its meeting on 16th January 2019.

 

In response to a question from a Member, the Associate Director, Inpatient and Crisis Services confirmed that there was a need to consider how people with mental health needs who did not meet the threshold for services could access appropriate support.  Oxleas NHS Foundation Trust was working to review the therapeutic interventions available across the Pathway, with a view to establishing a number of Service User Network Groups which offered ongoing support to people with mental health needs and could be accessed without a referral.

 

The Chairman led the Sub-Committee in thanking Estelle Frost, Adrian Dorney and Donvé Thompson-Boy for their excellent presentation which is attached at Appendix A.

 

RESOLVED that the presentation be noted.

6.

BROMLEY HEALTHCARE QUALITY ACCOUNT 2017/18 (BROMLEY HEALTHCARE) pdf icon PDF 3 MB

Minutes:

Jacqui Scott, Chief Executive Officer and Janet Ettridge, Director: Operations, Bromley Healthcare presented the Bromley Healthcare Quality Account 2017/18 to the Sub-Committee, which outlined the findings of a review into the quality priorities and performance during 2017/18, and looked forward to a planned improvement in the quality of services across five priority areas for 2018/19.  There was a statutory requirement for all NHS publicly funded bodies to provide their Annual Quality accounts to NHS England and for this to contain a supporting statement from the Health Scrutiny Sub-Committee.

 

During 2017/18, Bromley Healthcare had launched the Care Coordination Centre which went live on 1st January 2018 and offered a single point of access for all patients, carers and referrers into community services, proactively supporting the management of 25,000 Bromley Healthcare patients.  Significant progress had also been made in achieving Bromley Healthcare’s quality objectives including a 59% reduction in avoidable pressure ulcers, enhanced clinical record sharing with Bromley General Practitioners and implementation of Therapy Outcomes Measures.  The National Audit of Intermediate Care had highlighted Bromley Healthcare’s Rehabilitation Service as delivering some of the best outcomes for patients both regionally and nationally, and 98.14% of patients responding to the National Friends and Family test had stated they were ‘Likely’ or ‘Extremely Likely’ to recommend Bromley Healthcare’s services.  A number of innovative outcome-based contracts commissioned by the Bromley Clinical Commissioning Group had also been successfully implemented.  Five priority areas had been identified for improvement for 2018/19 which reflected learning from Care Quality Commission (CQC) inspections undertaken since 2016/17 and were underpinned by the five CQC core standards for a healthcare organisation comprising Safe, Caring, Responsive, Effective and Well Led.  This would include a focus on Bromley Healthcare staff following a significant period of change.

 

In considering the quality priorities for 2018/19, the Chief Executive Officer, Bromley Healthcare confirmed that the target of 3% for patient engagement was one of the measures by which Bromley Healthcare aimed to place patients at the centre of their care, and would be achieved by encouraging patients to provide feedback relating to their patient experience.  A Member queried the total direct cost per service user assessed by Bromley Healthcare which, at £175 per user appeared to be considerably more cost effective than the London and England average costs, and the Chief Executive Officer, Bromley Healthcare would provide further details to Members following the meeting.

 

In response to a series of questions from Members, the Chief Executive Officer, Bromley Healthcare advised that recruitment continued to be a concern in some areas of service provision but that work was underway to embed robust recruitment and retention practices across Bromley Healthcare and reduce the use of bank and agency staff, which had already proved effective for service areas such as the Rapid Response Team which was now fully-staffed.  Bromley Healthcare was currently developing a sustainable response to ongoing recruitment difficulties within the District Nursing service which had included a highly successful open day for newly qualified nurses and the introduction  ...  view the full minutes text for item 6.

7.

PRUH IMPROVEMENT PLAN - UPDATE FROM KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST (KING'S)

Minutes:

The presentation was withdrawn. 

 

Dr Angela Bhan, Managing Director, Bromley Clinical Commissioning Group gave a brief verbal update, advising Members that Matthew Trainer, Managing Director, Princess Royal University Hospital had recently been appointed as Chief Executive to Oxleas NHS Foundation Trust, and would be taking up his new role in Autumn 2018.

 

In discussion, Members generally agreed the importance of ensuring robust leadership and management processes were maintained at the Princess Royal University Hospital at both an operational and strategic level following the Managing Director’s departure.  A Member suggested that the Chairman write a letter to Ian Smith, Interim Chairman, King's College Hospital NHS Foundation Trust on behalf of the Health Scrutiny Sub-Committee emphasising the need for the right measures to be put in place to ensure the continued delivery of the Princess Royal University Hospital Improvement Plan. 

 

The Chairman requested that the Managing Director, Bromley Clinical Commissioning Group present an update on leadership and management at the Princess Royal University Hospital to the next meeting of the Sub-Committee on 17th October 2018, and that this include a briefing paper.

 

RESOLVED that the update be noted.

8.

EVALUATION OF WINTER SERVICES (CCG) pdf icon PDF 68 KB

To Follow.

Additional documents:

Minutes:

Dr Angela Bhan, Managing Director, Bromley Clinical Commissioning Group presented an evaluation of £628k of services commissioned to provide additional capacity and help manage increased seasonal demand during Winter 2017/18.

 

The Bromley Clinical Commissioning Group had commissioned a range of schemes that enhanced and provided additional capacity for key health services during Winter 2017/18.  The commissioned schemes were targeted towards admission avoidance, patient flow and primary care, and included a Community Matron resource, packages of care and emergency placement support and an additional Discharge Coordinator to reduce Delayed Transfers of Care.  Investment had also been made in Urgent Care Centres to maximise the efficiency of primary care services which had been supplemented by an increased number of General Practitioner home visits, with 274 patients visited in their own home as at the end of January 2018.  There had been a significant increase in attendance of health services during Winter 2017/18, and although performance had not met national standards it had been higher than in previous years and showed a considerable improvement in responsiveness and recovery rates.  Work was underway to identify learning from Winter 2017/18 that could benefit future planning, and this was likely to include earlier planning and mobilisation of schemes and the use of existing service provision to develop an integrated urgent and emergency care system in the community to reduce the need for hospital-based care and support.

 

In response to a question from the Vice-Chairman, the Managing Director, Bromley Clinical Commissioning Group explained that winter services tended to run until the end of April each year, after which planning could begin for the next winter period.  There was limited capacity to begin planning for the next winter period whilst winter services were still being provided; however the Bromley Clinical Commissioning Group recognised the value of earlier planning and mobilisation for some schemes to ensure that staff recruitment processes were completed in good time.  Annual leave was managed carefully during periods of high seasonal demand, and work continued across the National Health Service to move towards a seven-day service.  A Co-opted Member underlined the value of the increased GP Access Hubs scheme in providing 800 additional General Practitioner appointments per week during Winter 2017/18, and the Managing Director, Bromley Clinical Commissioning Group confirmed that this scheme had been highly successful and that it was planned to commission a similar scheme for Winter 2018/19.

 

The Interim Director: Programmes noted that the Local Authority and Bromley Clinical Commissioning Group continued to work collaboratively in developing a long term commissioning approach for key services within the care pathway.  New service delivery models were being developed for services such as domiciliary care, and these would be designed to deliver enhanced and additional capacity for the winter period. 

 

RESOLVED that the update be noted.

9.

JOINT HEALTH SCRUTINY COMMITTEE VERBAL UPDATE (JHOSC MEMBERS) pdf icon PDF 122 KB

Minutes:

The Sub-Committee considered the minutes of the meeting of Our Healthier South East London – Joint Health Overview and Scrutiny Committee held on 12th March 2018, at which a finance briefing on King’s College Hospital NHS Foundation Trust and the outcome of the Kent and Medway Stroke Service Consultation had been discussed.

 

RESOLVED that the update be noted.

10.

WORK PROGRAMME 2018/19 pdf icon PDF 59 KB

Minutes:

Report CSD18073

 

Members considered the forward rolling work programme for the Health Scrutiny Sub-Committee.

 

The Portfolio Holder for Adult Care and Health requested that King’s College Hospital NHS Foundation Trust be invited to present an update on inpatient nutrition and hydration to the next meeting of Health Scrutiny Sub-Committee on 17th October 2018, and that this update include representation from nursing staff and a dietician.

 

The Chairman invited Members of the Sub-Committee to provide details of any other items they wished to discuss at future meetings to the Clerk to the Committee.

 

RESOLVED that the work programme be noted.

11.

ANY OTHER BUSINESS

Minutes:

Dr Angela Bhan, Managing Director, Bromley Clinical Commissioning Group advised Members that work on the Bromley Health and Wellbeing Centre project was ongoing.  The establishment of a third Health Centre within the Borough to complement the Beckenham Beacon and the Orpington Health and Wellbeing Centre was one of the key proposals of the Bromley Out of Hospital Transformation Strategy, which had been developed jointly by the Bromley Clinical Commissioning Group and the Local Authority. 

 

It was planned that the Bromley Health and Wellbeing Centre would be one of three ‘hubs’ underpinning the new Integrated Care Networks and would play a key role in providing coordinated care to approximately 100,000 people via integrated services, as well as offering primary care services for Bromley residents including a Primary Care Access Hub and the relocation of the Dysart Medical Practice.  A preferred site for the development had been identified in the Bromley area and a planning application would be submitted in Autumn 2018. 

 

RESOLVED that the update be noted.

12.

FUTURE MEETING DATES

4.00pm, Wednesday 17th October 2018

4.00pm, Wednesday 16th January 2019

4.00pm, Wednesday 3rd April 2019

Minutes:

The next meeting of Health Scrutiny Sub-Committee would be held at 4.00pm on Wednesday 17th October 2018.

 

In response to a question from a Member, the Chairman confirmed that Health Scrutiny Sub-Committee meetings had been scheduled to take place at 4.00pm to maximise attendance by health partners.  The Chairman suggested that it might be possible to schedule Health Scrutiny Sub-Committee meetings to take place on the same day as Adult Care and Health PDS Committee meetings, but this was not generally supported by Members.

Appendix A: Reablement Workstream within Bromley Adult and Older People's Mental Health Directorate Presentation pdf icon PDF 66 KB

 

Original Text: