To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 3 July 2017.

The Minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 3 July 2017 were approved as a correct record.

Kim James updated Members on the previous concerns expressed by HealthWatch on the increased number of complaints received on the services being delivered by Basildon Hospital. That HealthWatch had been working closely with Basildon Hospital and that staff and volunteers had been invited to Basildon Hospital to ask questions and seek some reassurances. All incidents reported had been investigated and all complainants had received support by advocates and outcomes had been reached. Kim James informed Members that HealthWatch had continued to be heavily involved with Basildon Hospital and would continue to support residents.

Councillor Snell thanked Kim James for the update and stated that it was good that complaints had been addressed. A full report from Basildon and Thurrock University Hospital would be presented to the November Health and Wellbeing Overview and Scrutiny Committee.

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.

There were no items of urgent business.

No interests were declared.

No items were raised by HealthWatch.

Sarah Turner presented the report that updated Members on the procurement of the Carers Support, Information and Advice Service. The procurement would provide the opportunity to improve the services and reach out to carers over the age of 18 and ensure that the Council was fully compliant with the Local Authority responsibilities outlined within the Care Act 2014. The current services would be expanded to include the introduction of a low level assessments and a Carers emergency scheme.

Councillor Snell thanked the Officer for the report.

RESOLVED

1.         That the Health and Wellbeing Overview and Scrutiny Committee commented on the draft specification for the provision of the Carers Support, Information and Advice Service.

2.         That the Health and Wellbeing Overview and Scrutiny Committee noted that the procurement will commence on the 18 September 2017.

Monica Scrobotovici, Healthcare Public Health Improvement Manager, presented the report that updated Members on the Long Term Condition Profile Card that had been created by the Healthcare Public Health Improvement Team to respond to the high levels of variation within primary care across Thurrock in regards to individual needs, available resources and overall quality of services. A presentation of the tool was given that identified a visual overview of each practice that focused on the Long Term Condition case finding and management whilst also included some of the potential drivers and secondary care outcomes. General Practices were currently being visited by the Healthcare Public Health Improvement Managers and it was hoped that that all surgeries would be complete by the end of October 2017.

Councillor V Holloway stated that the Profile Card was an excellent tool and thanked Officers for the amount of work undertaken. Councillor V Holloway asked how many Practice Managers had been seen and whether action plans were in place. Monica Scrobotovici stated that 15 out of the 32 Thurrock practices had received visits from a Healthcare Public Health Improvement Manager to discuss the Profile Card and had received a good response with 14 out of the 15 practices having action plans created.

Councillor C Holloway thanked Officers for the report and asked for any benchmarking examples. Monica Scrobotovici stated that there are no exact examples to give but stated that there were two practices from Thurrock in the same group and that all practices would be seen.

Councillor Redsell questioned whether it was only the Practice Manager that could see the information on the Profile Card. Monica Scrobotovici stated that yes either the Practice Manager or the Lead General Practitioner could view the Profile Card. Monica Scrobotovici stated that work was being undertaken closely with patient participation groups and would be taking versions of the Profile Card to these events.

Councillor Redsell stated that the comment box appeared very small and how could feedback from patients be recorded in such a small space. Monica Scrobotovici stated that further comments would generate an Action Step which would include further information to be provided in consultation with the Practice Manager.

Ian Evans questioned the frequency of site visits. Monica Scrobotovici stated that these were carried out quarterly but was dependent on the availability of Practice Managers.

Councillor Collins questioned whether the Profile Card had any impact of the number of patients attending accident and emergency. Mandy Ansell stated that the evidence so far was interesting and that new contracts delivered extended hours that would hopefully keep people away from accident and emergency, although it was stated that general practitioners in the borough offered a variety of different appointment slots.

Councillor Snell stated that this was a fantastic and a very important tool to help general practitioner surgeries to provide better service for patients and thanked Officer for the hard work. Councillor Snell questioned whether this tool was unique. Ian Wake stated that the Long Term Conditions Profile Card  ...  view the full minutes text for item 17.

Roger Harris, Corporate Director of Adults, Housing and Health, presented the annual report on the operation of the Adult Social Care Complaints Procedure covering the period 1 April 2016 to the 31 March 2017 and explained that this was a statutory requirement and that the procedure was operated in accordance with the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. Roger Harris directed Members to the representations received during 2016/17 and stated that although the number of complaints had risen the category “Concerns” had been removed for this period and that been reflected in the complaints category. Members were referred to the number of compliments received and to the case studies detailed in the report.

Councillor Redsell questioned what “partial upheld” meant.  Roger Harris stated that a complaint could be made up of a many number of parts and only part of a complaint may have been upheld.

Councillor Redsell asked whether the number of complaints may go down next year. Roger Harris stated it was unwise to say definitely at this point as the service was under a lot of challenges but lessons had been learnt from the representations received.

Councillor Redsell stated that the complaints procedure should be made easier especially for the elderly residents of the borough.

Councillor Snell thanked Roger Harris for the report and stated that complaints could lead to a better service and lessons can be learnt to ensure that the service improved year on year.

RESOLVED

That the Health and Wellbeing Overview and Scrutiny Committee noted the contents of the report.

Mandy Ansell, Accountable Officer Thurrock NHS Clinical Commissioning Group, presented the report that provided Members with a summary of key developments in the Primary Care in Thurrock and provided an overview of the development of the Integrated Medical Centres. Mandy Ansell stated that a lot of resource would be required to improve Primary Care and that the Integrated Medical Centres would bring general practitioner surgeries together. That the mixture of skills would be presented to patients as part of the Patient Medicine Review and would include the use of a pharmacy partners. Mandy Ansell stated that the continued success of the Hubs offering evening and weekend appointments had been based on patient feedback. Mandy Ansell and Rahul Chaudhari, Head of Primary Care, would be presenting the work achieved so far at the National Conference in Manchester.

Councillor Collins thanked Officers for the good work and appreciated the hard work undertaken.

Kim James stated that the work so far had been challenging but was now evident that it was working with other ways of delivering care now in place. Kim James stated work would continue with residents to help better understand that the need to see a general practitioner could be addressed by visiting pharmacists or calling out paramedics.

Ian Evans questioned how the good work was being publicised. Mandy Ansell stated that the Clinical Commissioning Group had an active communications lead and worked creatively with HealthWatch. It was vital to reiterate this good message out to the community.

Councillor Redsell stated that good things were happening in Thurrock with good general practitioners going out on home visits to the elderly residents.

Councillor V Holloway echoed the positive comments made and asked Officers to explain the high resource put into primary care. Mandy Ansell stated that Thurrock Clinical Commissioning Group was the smallest in Essex and that the budget was based on population. With five staff focused on primary care alongside two members from the Public Health Team. The aspirations of the team were to get general practice surgeries to outstanding.

Councillor V Holloway stated that the successes were fantastic based on the resources available.

Councillor Snell stated that huge changes had taken place in the short space of time and that this had been achieved by working together and having achievable goals. Councillor Snell thanked Officers for their hard work.

RESOLVED

That the Health and Wellbeing Overview and Scrutiny Committee noted the contents of the report.

Mandy Ansell, Accountable Officer Thurrock NHS Clinical Commissioning Group, updated Members on the Joint Committee across the Sustainability and Transformation Plan Footprint and implications that may affect the Health and Wellbeing Overview and Scrutiny Committee. Mandy Ansell stated that the Clinical Commissioning Group had been instructed to work in a certain way and under a legal direction to form this Joint Committee. The third committee meeting would be held on Friday 8 September and encouraged Members to attend as part of the public gallery.

Councillor V Holloway questioned whether there were any other implications apart from the Health and Wellbeing Overview and Scrutiny Committee. Mandy Ansell stated that there were no lay representatives and no local partnership representatives on the Joint Committee but felt that they should be. Councillor V Holloway asked how, as the voice of the patient, this could be changed. Mandy Ansell stated that the Health and Wellbeing Overview and Scrutiny Chair could write to the Joint Committee Chair to encourage these representations. Councillor V Holloway further commented that similar colleagues should also be encouraged to write letters.

Roger Harris stated that he had concerns about any further development of this Joint Committee and that the risk of undermining local arrangements to take on extra powers. Roger Harris stated that some good work had already been undertaken at a local level and a fantastic relationship with the Clinical Commissioning Group was already in place. Roger Harris stated that he was nervous that the Joint Committee might take on too much responsibility and that a line should be drawn under the current list of services and no more should be added.

Councillors Snell and Collins both echoed Roger Harris comments.

Councillor C Holloway stated that caution must be taken going forward and asked what reassurances could be given going forward. Mandy Ansell stated that general practitioners would continue to fall under the Clinical Commissioning Group and that budgets still remained under her control and at this point in time these budgets were still fine.

Ian Wake stated that he, Councillor Halden and Roger Harris had plans to meet with the Regional Director, Dr Paul Watson, to discuss their concerns.

Mandy Ansell summed up and stated that a structure would be put in place that would include Public Health input.

Councillor Snell stated that there were concerns from Members that all representatives should be involved with the Joint Committee and proposed as Chair he would write to the Chair of the Joint Committee to encourage inclusion of patient groups and public health representatives into the Joint Committee.

 RESOLVED

That the Chair of the Health and Wellbeing Overview and Scrutiny Committee would write to the Chair of the Joint Committee to encourage inclusion of patient groups and public health representatives.

Roger Harris, Corporate Director of Adults, Housing and Health, presented the report and explained that the Thurrock Health and Wellbeing Overview and Scrutiny Committee had been approached by Essex and Southend Councils to look at the possibility of forming a single joint Health and Wellbeing Overview and Scrutiny Committee to look at the Mid and South Essex Sustainability and Transformation Plan and the Success Regime.

Roger Harris stated that this single joint Health and Wellbeing Overview and Scrutiny Committee could strengthen the voice of the local authority and have the opportunity to scrutinise the Sustainability and Transformation Plan footprint but recommended that it was not the right time to join up to this proposal at this stage. This was based on the risks that could undermine the work currently undertaken by the Thurrock Health and Wellbeing Overview Scrutiny Committee and other ways should be explored on working together with Essex and Southend Councils.

Councillor Redsell stated that this recommendation would undermine the work of the local authority which had a very good Health and Wellbeing Overview and Scrutiny Committee who had achieved a lot over the past few years and would not be supporting the proposal.

Councillor Collins echoed Councillor Redsell concerns and would not be supporting this recommendation.

Councillor V Holloway stated that work should be undertaken to explore ways of continuing to work with Essex and Southend but that the recommendation should be changed to reflect this.

Councillor Snell stated that there would be no benefit to having a further Health and Wellbeing Overview and Scrutiny Committee above the current Thurrock Committee and proposed that the words “without resorting to a Joint Health and Wellbeing Overview and Scrutiny Committee” be added to the recommendation.

All members agreed to the additional proposed wording.

RESOLVED

That Officers would continue to explore the most appropriate way for Essex, Southend and Thurrock to co-ordinate their approach to the Sustainability and Transformation Plan without resorting to a Joint Health and Wellbeing Overview and Scrutiny Committee and report back to Members in due course.

The Chair asked Members if there were any further items to be added or discussed for the work programme for the 2017-18 municipal year.

Members agreed to add a report on Cancer – 62 Days Wait Standard to the 16 November 2017 Committee.

Members agreed to merge the Fees and Charges Pricing Strategy 2018/19 (Adult) report with the Non-Residential Care Strategy report.

Members agreed to merge the Tilbury Accountable Care Partnership report with the Business Case for Tilbury Integrated Medical Centre report.

RESOLVED

1.         That the item Cancer – 62 Days Wait Standard will be added to the work programme for the 16 November 2017 Committee.

2.         That the item Fees and Charges Pricing Strategy 2018/19 (Adult) will be merged with the Non-Residential Care Strategy for the 16 November 2017 Committee.

3.         That the item Tilbury Accountable Care Partnership will be merged with the Business Case for Tilbury Integrated Medical Centre for the 18 January 2018 Committee.