The Chair welcomed Mrs Bev Bray to her first meeting as the proposed co-optee representing carers, although she had yet to be formally co-opted by Council, the Chair invited Mrs Bray to participate in the meeting.

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.

No such declarations were made.

To receive the minutes of the meeting held on 19 January, 2010.

Members were requested to receive the minutes of the meeting of the Health and Well Being Overview and Scrutiny Committee held on 19 January, 2010.

In respect of minute 41, ‘Members’ Code of Conduct – Declarations of Interest / Party Whip’, Councillor Roberts requested that the minute be amended so that her declaration of a personal interest in minute 52 (Adult Social Services - Charging Policy) read, “due to her being referred to in the report”.

In respect of minute 54, ‘Committee Work Programme 2009/10’ the Chair referred to the addition to the work programme of a small group of Members visiting pupils of 18/19, with learning difficulties, in their schools who were at the transition stage to adult social services and it was agreed that this would be arranged as soon as possible after the elections.

Resolved – That subject to the above amendment, the minutes be approved as a correct record.

The Director of Adult Social Services submitted a report which provided feedback on the progress of the review of the Wirral Safeguarding Adults process. Wirral Safeguarding Adults Partnership Board was overseeing the review. This area of work was externally monitored by the Care Quality Commission (CQC) and was also reflected in Wirral’s Comprehensive Area Assessment.

The aim of the review was to ensure that the current safeguarding process was operating in such a way that it was fully addressing the issues of protecting vulnerable people in Wirral and within the remit of all national and local directives and guidance.

Following an initial briefing with elected Members, training / awareness to highlight the issues of Safeguarding was due to be delivered to Members on 20 April 2010, 15 June 2010 and 15 September 2010. This would raise the profile and assist Members to identify what actions needed to take place should they be made aware of situations that appeared to be placing vulnerable people at risk of abuse or neglect.

A paper had also been circulated to the Committee from Steve Maddox and Kathy Doran, Chief Executives of Wirral Council and NHS Wirral and the Chief Superintendent, Merseyside Police, Jon Ward, entitled, ‘Wirral Protects – Safeguarding Adults in Wirral, A Strategic Approach 2010-2013’.

The report also provided information on a forthcoming Care Quality Commission inspection to be undertaken in May 2010 on Wirral Adult Safeguarding and Adults with Learning Disability services.

Responding to Members’ comments, Paula Neate, Reform Unit Manager and the Director stated that all partner organisations received training and within the Adult Social Services Department take up of training was high. They outlined the complaints process and the separation of functions within the department of the safeguarding unit which was not an operational team. The Safeguarding Board would be chaired by an independent chair, though the job description for this role had yet to be approved. In the short term the lead member would be a member of the Board and further proposals would be brought forward at a later date.  

Resolved –

(1) That the report and progress to date be noted.

(2) That Members confirm their attendance on the training programme with the Director of Adult Social Services.

Mike Fowler, Head of Service (Finance and Performance) gave a presentation on the progress made against the indicators for 2009/2010 in the third 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:

·  551 people supported by NHS Stop Smoking Service (target 516)

·  99% of equipment delivered within 7 days (target 93%)

·  601 new installations of Assistive Technology (target 562)

·  769 reduced packages as a result of re-ablement (target 750)

·  89.5% of people receiving intermediate care still at home 90 days later

·  Improved mortality rate from circulatory diseases

In his presentation, the Director also referred to key performance issues which weren’t achieving on target and these included:

·  Self directed support

·  Support to carers

·  People with learning disabilities in settled accommodation

·  People receiving a review in a year

In respect of the financial position the projected overspend for the third quarter was £2.5m (1.7% of gross budget). This remained a volatile position as activity over the winter months showed a further increase in unavoidable expenditure.

Responding to Members’ comments Mike Fowler and the Director stated that the March accounts were not yet finalised and elaborated on those areas of volatility. The Director also confirmed that he would inform Members of the latest position in respect of what overspend had been reported to Cabinet.

The Director also outlined how the issue of undertaking more reviews was being taken forward and the need to plan over a 12 month period. He assured the Committee that no additional resources were being spent to chase targets and that more reviews could in fact lead to economies.

Resolved – That the report be noted.

The Director of Adult Social Services submitted a report which set out the role of the Overview and Scrutiny Committee in Quality Accounts and the progress of NHS provider services in developing these Accounts.

A key component of the new Quality Framework would be a requirement for all providers of NHS services to publish Quality Accounts: annual reports to the public on the quality of health care services they delivered. The legal duty to publish these would be brought into force from April, 2010. The aim of Quality Accounts was to improve public accountability and to engage boards in understanding and improving quality in their organisations.

Over the last year the Department of Health had engaged widely with healthcare providers, commissioners, patient groups and third sector organisations in the development of Quality Accounts.

The Chair suggested that it would be useful if Wirral University Teaching Hospital, North West Ambulance Service and Clatterbridge Centre for Oncology could bring their quality account reports to future meetings of the Committee in the new municipal year.

Kathy Doran, Chief Executive, NHS Wirral, commented that with regard to the Cheshire and Wirral Partnership Trust, their report could be taken to the Cheshire and Wirral Joint Scrutiny Committee.

Resolved -

(1) That the report be noted.

(2) That Wirral Links provide copies of their statements in respect of Quality Accounts for 2009/10 to the next meeting of this Committee.

(3) That proposals for regular feedback on the priorities within the Quality Accounts are developed in order to be able to provide this Committee with year round dialogue in preparation for the 2010/11 Quality Accounts.

(4) That a further report on progress be brought to the June 2010 meeting of this Committee.

The Director of Adult Social Services submitted a final progress report on discharge from hospital which focussed on the outstanding actions from the action plans. The report also highlighted some additional actions and performance.

Reports to this Committee over the last year had identified a range of actions taken across the acute hospital, primary and community care, social care and housing services to improve the length of time patients stayed in hospital and the quality of their discharge.

The action plan agreed with the Committee had now been completed with only two actions still to be finalised. These were:

(i) That by April 2010 the revised Patient Information Leaflets would be finalised. These were sent to every patient for a planned admission and given to every urgent care patient on admission. These included all the required additions relating to discharge. In addition standard ward information sheets had been developed for the Model Wards and would be rolled out to all in patient areas during 2010.

(ii) A Task and Finish Group was finalising the work on Discharge Summaries and ensuring appropriate and timely information was sent to GPs and patients. This was in line with the national standards and would be further enhanced with the final implementation of Cerner (performance management system) for inpatients within the next two years.

In order to ensure that concentration remained firmly on prevention of admission, throughput and discharge a report was recently commissioned in January 2010 by the Chief Executives of NHS Wirral and Wirral University Teaching Hospital and the Director of Social Services. Senior managers from each organisation formed a ‘Discharge Turnaround Team’ charged to deliver a whole system report with recommendations to ensure that prevention of admission, throughput, shorter lengths of stay and timely, safe and appropriate discharges were considered in a multi-agency approach. This report had been received and approved and the actions identified would be implemented over the next six months.

Tina Long, Director of Strategic Partnerships, NHS Wirral, responded to Members’ comments and expanded on the close working relationship which the Trust had with the department. She acknowledged the need for more cross border work to be undertaken.

The Chair expressed her satisfaction at the progress made and that it was moving in the right direction.

Resolved -

(1) That the Committee is asked to note the continued progress being made in improving the experience of patients and their carers following admission to hospital and subsequent discharge.

(2) That the Committee notes the remit of the work undertaken by the ‘Discharge Turnaround Team’ and agree to receive a progress report from them in September 2010.

The Joint Director of Public Health and the Director of Social Services submitted a report which provided an overview of the findings of an assessment of the health needs of Wirral’s Black and Minority Ethnic (BME) communities, commissioned by NHS Wirral and undertaken by Icarus between May and November 2009.

The Joint Strategic Needs Assessment (JSNA) 2008 undertaken by NHS Wirral and Wirral Local Authority identified that there was a lack of robust data on the population prevalence of the BME community which made assessing levels of access to services particularly difficult. The current methods of capturing data around ethnicity and migration was not fit for purpose as population change was happening faster than in the past.

Conducting a comprehensive Health Needs Assessment (HNA) provided a structured way of assessing the health needs of BME groups in Wirral and whether existing services were meeting these needs and were delivered in a non-discriminatory way.

Quantitative and qualitative research methodologies were used to determine the BME experience and access to health and wellbeing services and to explore the correlation between seven of NHS Wirral’s health priorities and Wirral’s BME communities.

The randomised survey of 1728 households conducted had shown a relatively small increase in the size of BME population in Wirral since the 2001 census, which gave a figure of 3.56% of the population, compared to a total today of 5.83% (n = 18,291) (statistically adjusted figures).

The HNA had provided information on the health and wellbeing of BME groups and their access to services. Some of the findings were highlighted in the report. The full report would be made available through the JSNA web site in order to assist commissioners of services to take account of the health needs of BME groups.

Sue Drew, Deputy Joint Director of Public Health, responded to comments from Members and acknowledged the need for training for frontline staff to ensure they were culturally sensitive to the needs of BME communities.

Resolved –

(1) That the Committee notes the continued commitment of the Health and Well-being Partnership Co-ordination Group in addressing the health and well being needs of the black and minority ethnic (BME) population in Wirral.

(2) That the BME Health Needs Assessment report inform the Joint Strategic Needs Assessment 2009-10 which will be available for circulation in due course.

Marie Armitage, Joint Director of Public Health and Ann Tattersall, Head of Health and Well Being, Children and Young People’s Department, will give a presentation to the Committee.

Sue Drew, Deputy Joint Director of Public Health and Deborah Williams, Health Promotion Strategy Manager, NHS Wirral, gave a presentation to the Committee on sexual health promotion.

They gave information on HIV and AIDS prevalence in Wirral including by age, gender and routes of infection and also on other sexually transmitted infections (STIs).

In their presentation they outlined some of the measures being taken to prevent STIs in adults:

·  Campaigns to raise awareness – e.g. World Aids Day

·  Extending Genito-Urinary Medicine into the community

·  Terence Higgins Trust delivering high quality harm reduction and sexual health promotion work with the lesbian, gay, bisexual and transgender population as well as offering training and expertise to partners.

·  Wirral Drugs Service (screening – HIV and Hepatitis C)

·  Outreach sexual health clinic for working women

Measures being taken to prevent STIs in young people included:

·  Campaigns – e.g. Chlamydia screening in Schools and Colleges

·  Health and Well-being Charter for Wirral Children and Young People launched 2008

·  Wirral Sexual Health Policy and Guidance for staff working with under 19’s

·  Condom distribution

·  Education – SRE curriculum developments

They also went on to give details of additional school based programmes and outreach and education projects.

Both Sue Drew and Deborah Williams responded to Members’ comments and expanded on some of the statistics within the presentation and also on the Chlamydia screening programme within schools and the need to engage fully with parents and carers regarding sexual health education.

The Director of Adult Social Services informed the Committee that Sue Drew had been appointed as Joint Director of Public Health in Knowsley.

Resolved –

(1) That the presentation and the targeted work programme across all groups be noted.

(2) That the thanks of this Committee be accorded to Sue Drew for all her work on Wirral.

The Director of Adult Social Services submitted a report which gave an update on the work being undertaken by the Department of Adult Social Services in partnership with NHS Wirral on a number of initiatives to improve social care support in end of life care and to promote public awareness on issues of death, dying and bereavement.

Responding to comments from Members, Kathy Doran, Chief Executive, NHS Wirral, informed the meeting that NHS Wirral was currently working with Voluntary and Community Action Wirral (VCAW) in designing a bereavement development programme and identifying what services needed to be commissioned for all age groups across Wirral. This would include work with Age Concern.

Resolved – That this Committee notes the initiatives to raise awareness of death and dying and the programme of work being developed to improve end of life care support.

At the request of the Chair, the Director of Adult Social Services submitted a report which gave details of the actions taken to maintain services to the vulnerable people of Wirral during the recent severe weather conditions at the beginning of January.

With regard to lessons learnt, the Director remarked that Mark Camborne, Health, Safety and Resilience Operations Manager, would be putting this into context nationally and a report could be brought back at that point.

On a motion by the Chair it was –

Resolved – That the thanks and congratulations of this Committee be accorded to the staff of the Adult Social Service Department and the NHS and volunteers for their commitment and achievement in delivering services safely to service users during the severe weather.

The Chair will give a verbal update.

The Chair updated the Committee on the work of the dementia scrutiny panel and circulated a note on progress made. Key sources of evidence had included:

·  A focus group involving carers, held at Devonshire Centre (Age Concern)

·  An individual meeting with a carer

·  Written evidence from various sources

·  Meeting with local representatives of Age Concern and the Alzheimer’s Society

·  10 individual meetings with staff from Wirral University Teaching Hospital, Cheshire and Wirral Partnership Trust and NHS Wirral

The report went on to outline the next steps and the timetable for the remainder of the review which would be finalised in the new municipal year.

Resolved – That the report be noted.

The Committee received an update on its work programme, which included the proposed outline meeting schedule for the current municipal year.

A Member suggested that the North West Ambulance Service should be invited to a future meeting to report on incident response times.

Resolved – That the report and addition to the work programme be noted.

The Chair agreed to consideration of this item as a matter of urgent business in view of the topicality of the issue concerned.

Martin McEwan, Director of Communications and Engagement, NHS Wirral, gave a presentation to the Committee on the Implementation of National Summary Care Record on Wirral.

This was a national scheme across England which took an extract of essential medical history from GP records and made it available for staff who needed it within the NHS in England. There was no current plan to extend the information included, if so, further consultation would be required. Access would be limited to NHS staff with a need to view the information. He stated that the scheme would save lives, avoid delays and inconvenience for patients. There were strict security measures and an audit trail in place.

Martin McEwan gave details of the timeline for the implementation of the scheme, including

·  GP practices had been made ready for implementation in mid February 2010. 

·  Letters and information mailed out to patients in Wirral w/c 15 March

·  Patients able to opt out of having record created before 30 June 2010 (via GP practice)

·  Subsequently able to opt-out of the scheme at any time

·  Data uploads to “national spine”, and system live from September 2010

Responding to comments from Members, Martin McEwan explained that anyone opting out after the scheme had gone ‘live’ would have their data anonymised and it would not be available to view by NHS staff. There would be no additional keying in of data by GP practices as records were automatically loaded onto the ‘national spine’ from current GP records of medication, conditions and allergies and updated when a GP keyed in any further information, such as changes to medication.

He assured the Committee that there was no risk of the data falling into the wrong hands as the system was purely for NHS use. Kathy Doran, Chief Executive, NHS Wirral, re-emphasised this assurance as the NHS data systems were highly encrypted and Chief Executives themselves were personally accountable for the security of this data.

Resolved – That the presentation and comments be noted.

The Chair reminded the Committee of the need for training in respect of the Discharge from Guardianship under Section 7 of the Mental Health Act 1983 Panel.

The Director of Adult Social Services agreed that he would take this forward.

The Director of Adult Social Services paid tribute to Chris Batman, Deputy Director, who was attending his last meeting before retiring.

The Committee placed on record it thanks to Chris Batman for all his work for the authority and wished him a long, healthy and happy retirement.