Meeting documents
Cheshire CC-MB Wirral Joint Scrutiny Committee
Monday, 18th June 2007
Present
Chair
A Bridson
Councillors
R D Andrews, D Newton, S Proctor, A Richardson, DE Roberts, M Simon
Co-opted member
Francis Cook, Murdo Kennedy
Apologies
IO Coates, Mrs D H Flude, SR Mountney, Sarah Quinn, GCJ Watt
Index to Minutes
- Minute 1 - PROCEDURAL MATTERS
- Minute 2 - CHIEF EXECUTIVE'S REPORT
- Minute 3 - ADULT AND OLDER PEOPLE'S BED MANAGEMENT ISSUES
- Minute 4 - SICKNESS ABSENCE
- Minute 5 - PATIENT AND PUBLIC INVOLVEMENT FORUM ITEMS
Minute 1 - PROCEDURAL MATTERS
Minute Text :
It was moved by Councillor Proctor and seconded by Councillor Roberts that -
"Councillor A Bridson be appointed Chair of the Committee for 2007/08."
It was then moved by the Chair and seconded by Councillor Roberts that -
"Councillor Mrs D Flude be appointed Vice-Chair of the Committee for 2007/08."
There were no declarations of interest made.
It was suggested that the Joint Committee, which had previously resolved to meet 4 times a year, could perhaps meet 3 times a year in view of the Partnership Trust’s change to a Foundation Trust and the expectation that Scrutiny would focus on commissioning. After some discussion it was suggested that the January meeting be cancelled and that the October and April meetings go ahead but that the dates be changed to avoid Mondays.
Minute Decision :
Resolved- That,
(1) the Terms of Reference and Membership of the Joint Committee be noted;
(2) Councillor A Bridson be appointed Chair of the Committee for 2007/08;
(3) Wirral Council be appointed Secretary to the Joint Committee for 2007/08;
(4) Councillor Mrs D Flude be appointed Vice-Chair of the Committee for 2007/08;
(5) the minutes of the meeting of the Joint Committee held on 27 March be confirmed as a correct record; and
(6) the Committee agrees the number of meetings it wishes to hold be reduced to 3 per year and for this municipal year one be held in October and one in April, on dates to be agreed, and that the October meeting be held in the Cheshire County Sport Club and the April meeting in a venue in Ellesmere Port.
Minute 2 - CHIEF EXECUTIVE'S REPORT
Minute Text :
John Short, Chief Operating Officer of the Partnership Trust, briefed the Committee on various matters relating to the Trust, these included:
(i) Progress with Foundation Trust application -The Trust had continued to engage with Monitor (the independent regulator of Foundation Trusts) in preparation of an anticipated authorisation date of 1st July 2007. Membership currently stood at 3918 and all the elected Governor vacancies had been successfully filled. Contract development discussions with the Trust’s main Commissioners had continued and the respective PCTs believed they had now been able to reach agreement on all the key issues of principle that would enable contracts to be formally signed off by mid-June. The Monitor had asked the Trust to focus on membership and the aim was to double the membership over the next 12 months.
(ii) Sickness / Absence information - The mean sickness absence for 2006/07 was 5.75% down from 5.97% in 2005/06. He provided a breakdown of sickness by Division and sub-divisional level and also gave details of how the Trust was managing sickness and the measures being taken to reduce sickness levels. A sickness co-ordinator had been appointed in the HR Department. A scheme was being piloted in Wirral that incorporated a 24hr electronic telephone reporting system for staff who were unable to work due to sickness. The process would enable Managers to have immediate and full information at hand to enable them to both support staff and ensure appropriate cover was established if required.
(iii) Acute Inpatient Care & the Routine Outcomes Collaborative (ROC) - In preparation for the Healthcare Commission's improvement review of all acute inpatient facilities and services in England, the Trust’s Acute Care Forum had been benchmarking its services against the assessment criteria established by the HCC. As a result, local actions plans to address any identified areas of development had been put in place.
(iv) Performance Management Arrangements for 2007/08 - The Trust Board had recently adopted and formally signed off a Performance Management Policy. The Board continued to receive a Corporate Performance report detailing an appropriate range of key data that was designed to provide assurance to the Board of the Trust’s overall performance against a range of indicators.
(v) Health Care Commission - The Trust Board had now made its formal declaration to the Healthcare Commission of its compliance against all core standards and the developmental standards. The Trust was anticipating that it was likely to receive a formal visit by the HCC to verify and test out its declaration, though the Trust was confident its systems and processes would stand up to such scrutiny.
In response to questions raised by members John Short, made the following comments:
- Weekly reports were received on the FT membership, including geographical spread and breakdown by age, gender, ethnicity etc. He acknowledged that there was a need to recruit more younger people to the Trust, the minimum age for membership was 11.
- Every 1% of sickness cost the Trust £1m, so a reduction in sickness rates of 1 - 1.5% would result in a huge saving to the Trust. Monitoring would enable the Trust to target those areas where sickness was increasing.
- Future reports to the Committee would provide statistics on sickness in terms of days / hours lost and also give a breakdown in terms of types of sickness.
- The Wirral pilot would start on 2 July and would involve staff reporting in sick to one central point.
- It was a good idea to offer staff more opportunity to be involved in sports and exercise.
Minute Decision :
Resolved - That,
(1) the report be noted and future reports on sickness provide more details as referred to above.
(2) a further report be brought to the next Committee on FT membership including details of age and geographical breakdown.
Minute 3 - ADULT AND OLDER PEOPLE'S BED MANAGEMENT ISSUES
Minute Text :
Val McGee, Divisional Director at the Trust, introduced a report on the impact of the ward closures following the redesign of inpatient services at the end of November 2006. The redesign proposals were to ensure the efficient and effective use of inpatient beds and to enable service users to receive the most appropriate care in the most appropriate setting by offering choice. The report gave details of the impact of the ward closure programme on services, service users and staff.
In response to comments from Members, Val McGee, made the following comments:
- Ward staff were monitoring the impact of the service redesign on inpatients.
- High figures for violence from patients in Wirral wards in the Untowards Incidents report might reflect the acuity of the patients in those particular wards. The high figures for 'slips and trips' could be linked to older peoples' wards. Assessment of risk would be made in each individual's care plan and steps would be built in to minimise any risks.
Francis Cook gave positive feedback on the healing environment project at Clatterbridge and the Trust was to be congratulated on this initiative.
Murdo Kennedy submitted a paper, which was circulated to the Committee, on the funding of Crisis Resolution and Home Treatment (CRHT) Teams in Central and Eastern Cheshire and which set out in detail the concerns of the PPIF as follows, he asked that this be treated as a formal referral to the Health Scrutiny Committee:
"(1) Since effective CRHT Teams can reduce admissions, a yardstick used by CRHT pioneers such as Stephen Niemec was that 20 adult mental health beds per 100,000 population represented best UK practice, with best international practice of 10 beds per 100,000 (i.e. Australia and New Zealand) only being sustainable with an associated high investment in specialist services in the community.
(2) The Cheshire and Wirral Partnership NHS Trust (CWPNT) has reduced adult mental health bed numbers from around 30 beds per 100,000 five years ago to 21 beds per 100,000 by a year ago and to 13 beds per 100,000 now after the last round of financially driven cuts. The CWPNT PPI Forum is seriously concerned that these latest reductions have not been matched by the necessary investment by PCTs in CRHT staffing levels in that:
(a) compared with PIG (Policy Implementation Guide) guidance for CRHT of 14 staff and 0.5wte consultants per 150,000 of population, there is an average staff shortfall of 12% across the country;
(b) for the four CWPNT CRHT teams, staff shortfalls are West Cheshire 5%, Wirral 10%, East Cheshire 18% and Central Cheshire 33% - this means that the CRHT funding shortfall by the Central and Eastern Cheshire PCT is some two to three times the national average;
(c) the shortfall in consultant effort is even more striking, with only Central Cheshire having any dedicated consultant effort at all.
(3) Consequently, the CWPNT PPI Forum recommends that the Cheshire and Wirral Mental Health Joint Scrutiny Committee take up with Central and Eastern Cheshire PCT the need to fund an urgent reduction in their CRHT staffing shortfall to at least the national level of shortfall which has already been achieved by the Wirral PCT and the Western Cheshire PCT. If this is not done, there will be increasing concerns about sustainability and knock on effects and also the PCT will not be in a position to benefit from the possible service redesign by CWPNT now being trialled in Wirral."
In response, John Short, Chief Operating Officer of the Partnership Trust, informed the meeting that there were differing practices between different areas. It was not just a straightfoward funding issue as other factors were involved such as the quality of the environment, which in the Wirral and West Cheshire wards was of a better standard than those in the East.
Minute Decision :
Resolved -
(1) That this report be referred to the County Health and Adult Social Care Scrutiny Select Committee next week.
(2) That a further report be provided with an update to this Committee at the next meeting of this Committee.
Minute 4 - SICKNESS ABSENCE
Minute Text :
(See minute 2 ante).
Minute 5 - PATIENT AND PUBLIC INVOLVEMENT FORUM ITEMS
Minute Text :
Mr Murdo Kennedy of the PPIF had submitted the following items:
(1) Patient and Public Involvement Forum – Annual Report
The Annual report for the period 1 April 2006 to 31 March 2007 detailed the Forum’s work, achievements and activities and made further comments on significant issues and future work plans.
(2) Comments on Health Scrutiny Select Committee summary of report on Patient and Public Involvement
The Forum had prepared a paper for discussion at various meetings preparing for LINks giving its comments on:
a) What seems unfair comment;
b) What seems fair comment; and
c) Suggestions for what needs to be done
(3) A Possible Model for Powers and People LINks
This paper aimed to clarify issues and promote debate on:
(a) Powers of LINks;
(b) People in the Network; and
(c) People for the LINk “Board”
He gave a presentation to the Committee on the powers and people for LINks. A well funded LINk would be able to support 3 paid staff though it was likely that there would be considerably less funding for LINks than for PPIFs.
Minute Decision :
Resolved - That the report be noted.
(Minutes Published: 21 June 2007)