Agenda and draft minutes

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Items
No. Item

One Minute's Silence

The Adult Care and Health Overview and Scrutiny Committee stood in silence for one minute as a mark of respect for Councillor Chris Blakeley who had sadly passed away on 15 January 2020.

 

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37.

Apologies for Absence

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Minutes:

Apologies for absence were received from Councillor Samantha Frost, Yvonne Nolan, Graham Hodkinson, Director of Care and Health (DASS) and Karen Prior, Chief Officer Healthwatch Wirral.

 

38.

Members Declarations of Interest

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Councillor Moira McLaughlin

Personal interest by virtue of her daughter’s employment within the NHS.

Councillor Phil Gilchrist

Personal interest by virtue of his role as a Governor appointed to the Cheshire and Wirral NHS Partnership Trust, and as a member of the Health and Wellbeing Board.

Councillor Mary Jordan

Personal interest by virtue of employment within the NHS; and involvement in Incubabies, a charity raising funds for the neonatal unit at Arrowe Park; and her son’s employment as a GP.

Councillor Sharon Jones

Personal interest by virtue of employment within the NHS.

Councillor Christina Muspratt

Personal interest by virtue of her daughters’ employment within the NHS and as a GP.

Councillor Tony Norbury

Personal interest by virtue of his daughter’s employment within Adult Social Services.

 

39.

Minutes pdf icon PDF 105 KB

To approve the minutes of the meeting of the Adult Care and Health Overview and Scrutiny Committee held on 19 November 2019 as a correct record.

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Minutes:

Resolved – That the minutes of the meeting held on 19 November 2019, be approved.

 

40.

Clatterbridge Sub-Acute Ward Update pdf icon PDF 545 KB

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Minutes:

Anthony Middleton, Chief Operating Officer Wirral University Teaching Hospital NHS Trust introduced his report that provided a progress update in respect of the 30-bedded Transfer to Access (T2A) facility, Grove Discharge Unit (GDU), that came into operation at the end of November 2018, operating on the Clatterbridge site. The report focused specifically on performance within the Unit for the 6-month period from July to mid December 2019.

 

The report provided comprehensive information on key areas relating to the T2A / GDU, namely:

 

  • Functionality of the Unit;
  • Admission and Discharge Activity Data;
  • Patient Outcomes (including destination on discharge and readmission for acute care);
  • Length of Stay (LoS) Data;
  • Quality Assurance and Patient Experience;
  • Future Sustainability; and
  • Further Opportunities to Optimise Care.

 

The Chief Operating Officer Wirral University Teaching Hospital NHS Trust provided a verbal update on the two year contract running from November 2018 that provided T2A, and informed on arrangements for clinical care and consultation in respect of contract extension should this occur.

 

Members questioned the Chief Operating Officer on levels of patient transfer to home, rehabilitation and / or re-admissions. Additional questions followed, regarding procurement (an open market tender), employment contract arrangements for staff and medical cover in the unit. Members noted that the unit had been inspected by the Care Quality Commission in November 2018 and results published in January 2019 had rated the service as ‘good’.

 

The Chief Operating Officer Wirral University Teaching Hospital NHS Trust informed that the Acute Trust as commissioner, continued to hold 4 Seasons (the contractor) to account against its contract obligations, and compliance against CQC standards.

 

Resolved – That the report be noted.

 

41.

Annual Social Care Complaints Report 2018/19 pdf icon PDF 106 KB

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Simon Garner, Lead Commissioner for All Age Independence introduced the report of the Director of Care and Health that informed that it was a statutory requirement to produce an annual report about complaints made by, or on behalf of people who receive support or services from Adult Social Care. His annual report also provided a mechanism by which the Council could monitor the quality and effectiveness of services and of its complaints procedure.

 

This report provided an overview and analysis of all complaints received during the reporting period 1 April 2018 to 31 March 2019; and included a summary of identified issues, examples of service improvement and details of future objectives for 2019/20. Comparisons from the previous reporting period, i.e. from 1 April 2017 to 31 March 2018 had been included where available.

 

Members noted that the report was to be published on the Council’s website, and made available to managers and staff, elected members, residents and inspection bodies. During 2018/19, just over 10,884 service contacts had been received from new clients by Adult Social Care. At the beginning of April 2018, just over 4,098 people had been provided with ongoing long-term support.

 

Members were apprised that each Complaint was acknowledged within 3 days and complainants will be informed of the expected timescale at the outset. In all cases complaints should be dealt with expediently. In response to a Member question Mr Garner informed that some complaints, of a more complex nature, would require more time to investigate and resolve and that the maximum amount of time allowed for dealing with any complaint was six months. Investigations were conducted in an impartial, reasonable and proportionate manner, ensuring that complaints were managed effectively at all stages of the procedure by having clear and straightforward systems in place to capture complaints and that these processes are readily accessible to all service users, feeding into Social Work procedures.

 

Members noted the increase in the number of financial concerns and levels of complexity. Looking at common complaints against providers, information for which was fed into the services database for analysis.

 

Chair questioned the procedures relating to complaints to private provider, and how they were reported into the department.

 

Mr Garner informed that Homes were required to tell how many complaints and that during contract meetings, they were specifically asked about their responses. The mechanisms looked to enhance the complaint procedure to evidence satisfaction regarding outcomes.

 

Members highlighted a concern that problems could arise where Care Homes don’t forward complaints or information to Wirral Council if no satisfactory results followed any actions identified. Mr Garner advised that evidence for this varied, but generally people were aware of complaints procedures, but this would be followed up.

 

The Chair thanked the Lead Commissioner for All Age Independence for his report.

 

Resolved – That the report be noted.

 

42.

Adults Safeguarding Annual Report 2018/19 pdf icon PDF 87 KB

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Lorna Quigley, Director of Quality & Patient Safety Wirral Health and Care Commission introduced the Annual Report of the Merseyside Safeguarding Adults Board (MSAB) that provided an overview of the work undertaken by the MSAB, its memberships and terms of reference.

 

Ms Quigley updated the Committee on the work of the MASB established in April 2017 and how it consisted of 4 Local Authority areas (Liverpool, Sefton, Knowsley and Wirral). She further informed that Core Duties with the Care Act 2014 required the MSAB to:

 

  • Publish a Strategic Plan;
  • Arrange safeguarding Adult review in line with S44 of ‘The Act’; and
  • Publish an Annual Report.

 

Ms Quigley further informed that the adult population across the geographical areas of Knowsley, Liverpool, Sefton and Wirral (who made up the MSAB) was approximately 983,970 and that Sefton and Wirral had the highest numbers of residents aged 85+ and an adult population of 255,090.

 

Members were apprised of the MSAB achievements in 2018/19 that included - Voices project (service user and frontline practitioner); Establishment of a Single SARS process; Self neglect guidance for professionals; and National Safeguarding week. Members also received an update on the priorities for 2019/20 that included a peer review in January 2020 - to review the effectiveness of the board and continuation of the ‘Voices’ project.

 

Ms Quigley informed Members of the complexities relating to reporting of types of abuse apprising Members of increase in the reporting of abuse but a decrease in reported levels of Domestic Violence. Work was continuing in an effort to ‘unpick’ these statistics – an element of which related to the inclusion of property damage as part of the crime reporting clasifications.

 

Another area of increase included that of financial abuse – again affected by more detailed classifications and assessment which included changes to individuals living conditions, inability to pay bills, and changes to signatures and wills.

 

Members were also apprised of examples of psychological abuse – now coming under more scrutiny – and as such provided a new concept in the recording and mapping of this category of abuse, including its relationship to neglect. Identification of symptoms included fires/hoarding which had led to deaths. Such examples had come about as a result of increased referrals from healthcare workers and were often taking place in and individuals own home, by people known to victim. Other areas of work involved investigations into sexual exploitation – which can now involve social media.

 

The Chair stated that 3 areas had already been identified by the Adult Care and Health Overview and Scrutiny Committee as priorities for review, namely: domestic violence (subject of a report to the next meeting of the Committee); people affected by county lines and gangs use of vulnerable people (workshop); and modern day slavery – where the Local Authority is often the first responder. The Chair added that in the instance of Care Homes having been classed as inadequate – why was this too not classed as a safeguarding issue for all residents.

 

The Chair thanked  ...  view the full minutes text for item 42.

43.

Urgent Care Transformation - Progress Update pdf icon PDF 162 KB

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Dr Paula Cowan, Chair Wirral Clinical Commissioning Group (CCG) introduced the report of the Director of Commissioning Wirral CCG that provided an update on the arrangements in place for the delivery of the NHS Long Term Plan that aims to ensure patients get the care they need fast and to relieve pressure on Accident and Emergency Departments (A&E). The report informed that analysis of data showed that half of the patients that attend A&E could have been treated in a more appropriate setting to deliver the same outcome, e.g. community health venues, pharmacies etc. The additional pressures meant that those patients, who were very poorly and in need of emergency interventions, might not be seen as timely as they could be.

 

The report outlined the current position of the urgent care transformation work with regards to the Interim Urgent Treatment Centre on the Arrowe Park Hospital Site in addition to the community urgent care offer. This included:

 

Interim Urgent Treatment Centre

 

  • Implementation of an Interim Urgent Treatment Centre (IUTC) on the Arrowe Park Hospital site, operational from the 19th December, 2019

 

Hospital Re-development Programme

 

  • Capital funding secured to assist in the re-development of the Arrowe Park Hospital site, including the urgent care footprint with the development of the Emergency Department and the IUTC, creating a single front door to access urgent and emergency care.

 

  • This programme is scheduled to commence in spring 2020 with a 3 year programme of works which will see the UTC opening in 2023 (subject to programme change). 

 

Primary Care Hub Model

 

  • The introduction of Primary Care Hubs across Wirral will enable all age walk in access as well planned GP and Nurse Appointments. The hubs will be located in the following locations: Birkenhead Medical Centre, Victoria Central Hospital and Eastham Clinic.

 

Dr Cowan informed that whilst the main UTC would not be completed until 2023, it was recognised that there remained a need to provide the highest quality, safest and most effective urgent care for the people of Wirral. She added that by taking a phased approach to full implementation allowed the CCG to test out new ways of working and fully embed new clinical pathways and working processes, prior to the main UTC. Point of Care Testing would soon be live in the interim UTC, meaning that patients could be seen at the UTC instead of potentially having to attend A&E for low level tests. The interim UTC also allowed an increase in the number of patients streamed from A&E, freeing clinicians up to treat those most in need of emergency care and treatment.

 

Dr Cowan further informed that the new model of care included replacement of the existing Minor Injuries/Illness services at Gladstone (formerly Parkfield) and Moreton Minor Injuries and Illness Units (MIU). The provision of GP extended access appointments and a specific dressing and wound care clinic (for the Moreton area) will mean that patients can still access same day urgent care locally to them. Patients will be  ...  view the full minutes text for item 43.

44.

Pooled Fund Arrangements 2020/21 Scrutiny Report pdf icon PDF 85 KB

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The Chair introduced the report of the Head of Intelligence (Statutory Scrutiny Officer) that provided feedback from the Adult Care and Health Overview and Scrutiny Committee workshop held on 30 October 2019. Requesting that the Committee note the work undertaken 

 

The Head of Intelligence’s report informed that the Joint Strategic Commissioning Board (JSCB) had resolved to support a proposed Section 75 agreement in relation to the Wirral Health and Care Commissioning Pooled Fund. This agreement set out a financial governance and decision-making process in order to strengthen the establishment of a single health and care commissioner for Wirral. Subsequently, this decision was ‘called-in’ in accordance with Council procedure rule/standing order 35 on the basis that there had been limited opportunity for Elected Members to consider the contract and undertake the in-depth scrutiny necessary.

 

Further examination of the proposals took place as a result of this ‘called in’ decision, with the matter referred to full Council in December 2018. As a result of this democratic process, Council endorsed the need for ‘improved and early dissemination of information to Elected Members’ and requested that the Joint Strategic Commissioning Board (JSCB) ensure that a meaningful dialogue with relevant Overview and Scrutiny Committee Members was established.

 

The report further informed that a Member workshop for all Overview and Scrutiny Members had been convened in October 2019 in order that current integrated care arrangements could be reviewed and new arrangements for 2020/21 be scrutinised fully. One of the key priorities for Members in undertaking this process was to ensure there was comprehensive engagement with service users, those close to service users and other stakeholders impacted by services included within the pooled fund agreement. Representations were made by patient, carer and social care staff spokespersons, thus fulfilling the recommendation made by the Adult Care and Health Overview and Scrutiny Committee in 2018/19 that improved engagement take place and the participation of patients and frontline staff in health scrutiny be encouraged.

 

As a result of the work undertaken, the following conclusions and findings were recommended for consideration by the Wirral Joint Strategic Commissioning Board, namely:

 

Pooled fund budget performance reporting

Detailed financial reporting of pooled fund budget performance should continue to be shared with Elected Members so that they may have sight of the full budgetary position, financial performance and funding breakdowns. It was recommended that commissioners work closely with Elected Members to ensure this oversight is included in the Council’s revised governance arrangements from May 2020.

 

Continued engagement with service users or those close to service users, and continued use of external stakeholders where relevant

Members welcomed the opportunity to engage with those affected by services that were included in the pooled funding arrangements and were keen that they play a fundamental role in ensuring legitimate scrutiny of services. Participation should be encouraged by way of Member visits, involvement in advocacy sessions or (where possible) through service user attendance at Council meetings.

 

Further promotion of the NHS Health Passport Scheme on Wirral

Members recognised the benefits  ...  view the full minutes text for item 44.

45.

Adult Care and Health Overview & Scrutiny Committee Work Programme Update pdf icon PDF 96 KB

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The Chair introduced the report of the Head of Intelligence, Statutory Scrutiny Officer that provided an update regarding progress made since the last Committee meeting held on 19 November 2019. The report informed that the current work programme was made up of a combination of scrutiny reviews, workshops, standing items and requested officer reports.

 

The update report provided the Committee with an opportunity to plan, review and evaluate its work across the municipal year. The work programme for the Adult Care and Health Overview and Scrutiny Committee for the remainder of the 2019/20 municipal year was attached as Appendix 1 to the report.

 

The report also contained a list of topics for future consideration, work programme activities with suggested dates / deadlines.

 

At the request of the Chair, and with the agreement of the Committee it was agreed that a number of topic areas arising from the recent Public Health Annual Report be included into the Adult Care and Health Overview and Scrutiny Committee Work Programme, namely:

 

  • Housing;
  • Levels of Obesity;
  • Air Quality;
  • Vaccination Rates;
  • Dental Hygiene; and
  • Factors influencing mortality rates across the borough.

 

The Chair further requested that the first item of report (to the next meeting of the Committee) focus on the Public Health perspective on Wirral’s Housing i.e. quality, availability (affordability); and the quality of the private rental market.

 

Members also agreed that a Workshop on the subject of ‘County Lines’ be arranged before April, and also flowing on from the conclusion of work undertaken in respect of the Modern Slavery Workshop a report be submitted to the Committee on specific areas where people were not properly employed and what actions are being taken – to include detailed figures e.g. prosecutions.

 

Resolved – That, subject to the inclusion of the additional items of review, the report be noted.

 

46.

Date of next meeting

A special meeting of the Adult Care and Health Overview and Scrutiny Committee will be held at 18:00hrs on Wednesday 29 January 2020, to consider aspects of the Council Budget 2020/21 falling under its purview.

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Minutes:

Members noted that a special meeting of the Adult Care and Health Overview and Scrutiny Committee was to be held at 18:00hrs on Wednesday 29 January 2020, to consider aspects of the Council Budget 2020/21.