Members are asked to consider whether they have personal or prejudicial interests in connection with any item(s) on this agenda and, if so, to declare them and state what they are.

Members are reminded that they should also declare, pursuant to paragraph 18 of the Overview and Scrutiny Procedure Rules, whether they are subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.

Members were asked to consider whether they had a personal or prejudicial interest in any matters to be considered at the meeting and, if so, to declare them and state what they were. Members were reminded that they should also declare, pursuant to paragraph 18 of the Overview and Scrutiny Procedure Rules, whether they were subject to a party whip in connection with any matter to be considered and, if so, to declare it and state the nature of the whipping arrangement.

Councillor McLaughlin declared a personal interest in minutes 37 (Adult Social Services - Charging Policy – Service Users Residing at "In House" Supported Living Units During the Period 1997 to 2003), 38 (Progress Report on Action Plan in Relation to Public Interest Disclosure Act 1998 (PIDA)) and 39 (Charging Arrangements for Supported Living in Wirral 1997 to 2003) due to her friendship with an interested party.

The Chair informed the meeting that, having taken advice from the Director of Law, HR and Asset Management, the Committee should not consider items 10 and 12 on the agenda ‘Adult Social Services - Charging Policy – Service Users Residing at "In House" Supported Living Units During the Period 1997 to 2003’, and ‘Charging Arrangements for Supported Living in Wirral 1997 to 2003’ as their consideration had been deferred by the Audit and Risk Management Committee at its meeting on 3 November.

To receive the minutes of the Health and Well Being Overview and Scrutiny Committee held on 8 September, 2009.

Members were requested to receive the minutes of the meeting of the Health and Well Being Overview and Scrutiny Committee held on 8 September, 2009.

In connection with minute 26, Co-opted Membership, the Director of Adult Social Services reported upon the progress which had been made in respect of the co-option of representatives from 3 groups. Susan Lowe, a person who used services, was chair of the Direct Payments group and regular attendee at the Committee would be happy to be co-opted as a representative for ‘Service users under the Older People’s Parliament age group’. In respect of the ‘Black and Minority Ethnic Community’ and ‘Carers’ groups, Annette Roberts, Chief Executive Officer of Voluntary and Community Action Wirral, had agreed to co-ordinate nominations and elections, if necessary, for a representative from each of these two groups as co-opted members.

Resolved – That the minutes be approved as a correct record.

The Quarter 2 Performance Report on activities relevant to Health and Well Being Overview and Scrutiny Committee will be available to view in the web library and a presentation will be made by the Director of Adult Social Services.

The Director of Adult Social Services gave a presentation on the progress made against the indicators for 2009/2010 in the second quarter and key projects which were relevant to the Health and Well-Being Overview and Scrutiny Committee.

Outlining what was working well, he reported the following:

• Older people achieving independence through rehabilitation / intermediate care was exceeding the target
• Carers receiving needs assessment or review and specific carers’ service advice and information were exceeding the target.
• Timeliness of social care packages following assessment
• “Active8Success” centre for health and wellbeing opened in Birkenhead
• Reductions in alcohol harm related hospital admissions

In his presentation, the Director also referred to key performance issues and key risks and reported that because of additional grant funding for the extra care housing scheme, the capital budget had increased from £127,000 to £5.830 million.

The Director also read out a letter from a person who had recently benefited from the range of integrated services now being provided in Wirral. The HART service being specifically praised, with the person clearly giving testimony to the excellent outcomes for her from the support provided.

In respect of financial monitoring the 2009/10 efficiency targets were £6m (6.5% of net budget), although due to in year budget pressures including, increased activity (residential/nursing placements), staffing costs and unachievable income targets the projected savings would be £4.8m. An action plan was in place to deliver additional in year savings.

Resolved – That the report be noted and a further report be brought to the Committee in the New Year.

Following the Personalisation training session on 29 October, this is an opportunity for members to ask any follow-up questions.

The Chair invited Members to make comments on the training session which had been held on 29 October on Personalisation and informed the Committee that for any Members who were unable to attend, the Director would be happy to provide information on the issue. Members who had attended welcomed the training which they had found to be most informative.

The Director of Adult Social Services submitted a report on the progress being made in improving the experience of patients and their carers following admission to hospital and subsequent discharge.

It had long been recognised that patients admitted to hospital in Wirral had longer lengths of stay for patients than the national average and that there had been many years of over reliance on acute hospital services by primary and community services with a pattern of under developed community services. In order to address this, Health and Social Care had established a range of services to prevent avoidable hospital admissions and reduce the length of time that people stayed in hospital, including Wirral Home Assessment and Reablement Team (HARTS), Wirral Admission Prevention Service (WAPS) and Intermediate Care.

By reviewing and improving the admission and discharge processes the trust could improve the patient experience by reducing the number of days spent in hospital, and save bed days thus increasing the capacity and saving money. The ‘Better Care Better Value’ national productivity metrics estimated that Wirral Hospital Trust had the potential to save approximately £11.7 million by reducing the amount of time spent by patients in excess of the best performing length of stay by 25%.

An economy wide action plan developed through the Wirral Discharge Planning & Review Group had identified some key practices and issues which needed to be reviewed and challenged in order to significantly improve the experience of patients and improve the patient flow from assessment in A&E or other assessment areas to their safe discharge from hospital. An appendix which showed an update of the Wirral UTH action plan was submitted with the report and was due to be operational across the hospital from January 2010. 

Pat Higgins, Assistant Director, Wirral UTH NHS Foundation Trust, informed the meeting that there were regular visits from the Patient Advice & Liaison Service (PALS) representatives on the hospital wards who actively sought patients’ comments and concerns. Patients should not be taking decisions about their future long term care from a hospital bed. She also commented upon the turnaround time by the pharmacy for take-home medication and explained that the hospital was looking at ways to improve this.

Both Pat Higgins and Kathy Doran, Chief Executive, Wirral NHS, responded to Members’ comments and informed the Committee of the savings which would need to be made by the NHS over the coming years due to the likely constraints of the forthcoming Government Comprehensive Spending Review. Cumulatively these would amount to £15m in 2011, £30m in 2012 and £45m in 2013.

The Chair referred to the Committee’s Discharge Scrutiny Review (minute 76 – 25/03/09 refers) and circulated a paper which compared those recommendations to the actions identified in the Action Plan. On a motion by the Chair, duly seconded, it was:

Resolved –

(1) That this Committee notes progress in improving the experience of patients and carers following admission to hospital and subsequent discharge.

(2) That this Committee requests that the specific recommendations from  ...  view the full minutes text for item 32.

Pat Higgins, Assistant Director of Strategy and Planning, Wirral University Teaching Hospital NHS Foundation Trust, submitted a report which gave details of the progress being made in eliminating mixed sex wards at Arrowe Park Hospital.

The national operating framework for 2009/10 required providers, through their respective PCTs to publish by March 2009, plans to deliver substantial reductions in the number of patients who reported that they shared sleeping or sanitary accommodation with members of the opposite sex.

The Health Secretary had announced in January that performance measures would be put in place via the standard contract from April 2010 to ensure that same sex accommodation was provided for every patient. The noted exception to this was for patients who needed specialist or urgent care, where providing fast, effective care for the patient might take priority over providing same sex accommodation.

To support this programme, the Department of Health had made available a £100 million Privacy and Dignity Challenge Fund against which Trusts could bid. WUTH was allocated £900,000 to effect the necessary changes to the ward layout. To meet the April 2010 deadline, a programme of work had been agreed to provide single sex accommodation to the required standard and this was detailed in the report.

Responding to Members’ comments, Pat Higgins informed the Committee that the work was scheduled to be completed by mid-March, 2010. Single rooms were allocated primarily on the basis of clinical need. She also detailed the numbers of beds available for medical assessment, surgical assessment and in the clinical decision unit.

Resolved –

(1) That this Committee notes the progress being made at Wirral University Teaching Hospital (NHS Foundation Trust) to deliver same sex accommodation by the target date of April 2010.

(2) That a further update report be submitted to the Committee in six months time.

The Director of Adult Social Services submitted a report which provided an update on service developments proposed and approved in February 2008 and later in September 2009 by NHS Wirral. They were aimed at supporting the delivery of medium and longer term homelessness targets and supported the Local Authority in the development and delivery of the Wirral Homelessness Strategy and NHS Wirral in meeting the health needs of local people who were homeless or at risk of homelessness.

Lesley Hilton, Health and Housing Programme Manager, NHS Wirral, presented the report and responded to Members’ comments on a number of issues raised, including training for hospital staff in identifying the homeless, access to GPs and official counting methods of rough sleepers. She also outlined the proposed move to the commissioning of a mental health practitioner and two nurse practitioners who would provide support for homeless people in hostels and organisations working directly with the homeless.

On a motion by Councillor Teggin, duly seconded, it was:

Resolved –

(1) That the report be noted and this Committee welcomes the steps taken to train staff to identify the homeless; recognise better their needs and to identify those best placed to help and to implement procedures to improve links with these partners.

(2) That a further report be brought to this Committee in 6 months.

The Chief Executive of NHS Wirral submitted a report which outlined the 2008/09 Annual Health Check performance of the four Wirral based NHS organisations, as published by the Care Quality Commission (CQC) on 15 October 2009. The annual rating was made up of a number of components, which the CQC combined to produce scores for ‘Quality of Services’ and ‘Quality of Financial Management’.

Appendices to the report gave details of the components and provided a national overview by type of organisation.

NHS Wirral, Wirral UTH NHS Foundation Trust and the Cheshire and Wirral Partnership NHS Foundation Trust had all been rated as ‘Good’ for Quality of Services and the Clatterbridge Centre for Oncology NHS Foundation Trust had been rated as ‘Excellent’. Three of the four had achieved an ‘Excellent’ rating for Quality of Financial Management, with NHS Wirral achieving a ‘Good’ rating.

Both Kathy Doran, Chief Executive of NHS Wirral and Pat Higgins, Assistant Director, Wirral UTH NHS Foundation Trust, responded to Members’ comments and informed the Committee that in respect of the CQCs comment on the organisation of decontamination services ‘not being met’ at the Wirral UTH, the hospital’s capital programme did include provision for the hospital to have its own decontamination unit by April 2010.

Resolved – That this Committee notes the outcome of the Care Quality Commission’s Annual Health Check of NHS organisations in Wirral.

Kathy Doran, Chief Executive, NHS Wirral, will give a verbal update on the latest situation.

Kathy Doran, Chief Executive, NHS Wirral, gave an update on the latest situation with regard to swine flu. Recent weeks had seen a tailing off of cases across Merseyside and the previously anticipated 6 week peak in cases was not now expected. In Wirral the number of cases was lower than the national average.

By the end of the week every GP surgery would have 500 batches of the swine flu vaccine available for vulnerable groups.

The Director of Adult Social Services reported that the authority had solid, robust working arrangements in place and was as well prepared as possible.

Resolved – That the comments of Kathy Doran and the Director be noted.

At the request of the Chair, three reports, which had been to the Audit and Risk Management Committee had been submitted for the Committee’s consideration.

The Chair informed the Committee that the Audit and Risk Management Committee had expressed the view that consideration of two of the reports, this one and ‘Charging Arrangements for Supported Living in Wirral 1997 to 2003’ should be deferred until such time as a final update report had been resubmitted to the Audit and Risk Management Committee.

With the agreement of the Committee consideration of this item was deferred.

The Director of Adult Social Services submitted a report which had been considered by the Audit and Risk Management Committee at its meeting on 3 November, 2009 (minute 44 refers). The report updated the Committee on the actions undertaken by his Department in response to the Public Interest Disclosure Act 1998 (PIDA). The report set out key actions which had been completed by January 2009, at which point this report was delayed whilst the investigation into audit and disciplinary matters was undertaken.

The report went on to list those actions which had been completed since January 2009 and also detailed any matters which remained outstanding.

The Chair read out the resolution of the Audit and Risk Management Committee in respect of this item which was to note the report and it was then:

Resolved – That the report be noted.

With the agreement of the Committee consideration of this item was deferred.

The Committee received an update on its work programme, which included the proposed outline meeting schedule for the current municipal year, and progress on the in-depth panel review.

Responding to comments from Sandra Wall, Maura Noone, Head of Integrated Communities and Well-Being, remarked upon the development of an intervention strategy to help with the issue of older people living in their homes which had perhaps become unsuitable over time for their needs now. The issue perhaps only being addressed when a crisis occurred. She commented upon the need to work with other partners in public services to develop more services and initiatives for intervention at an earlier stage.

A report on a strategy would be brought to a future meeting of the Committee and it was hoped that a strategy would be in place by March 2010.

Resolved – That the report and comments be noted.