Agenda and minutes

The Chair reminded the Scrutiny Committee that this would be the last meeting attended by Councillor Bryan Leck as he would not be seeking re-election at the forthcoming local elections. The Chair highlighted Councillor Leck’s long service, including his membership of Cheshire County Council, being the first Mayor of the Metropolitan Borough of Stockport, his Chairmanship of the Regional Health Authority and being a previous Chair of the Health Scrutiny Committee. On behalf of the Scrutiny Committee, the Chair thanked Councillor Leck for his service to the people of Stockport and wished him well for the future.

To approve as a correct record and sign the Minutes of the meeting held on 1 April 2014.

The Minutes (copies of which had been circulated) of the meeting held on 1 April 2014 were approved as a correct record and signed by the Chair.

Councillors and officers were invited to declare any interests they had in any of the items on the agenda for the meeting.

The following interests were declared:-

Personal Interests

There were no call-ins to consider.

To consider a report of the Chief Executive of Stockport NHS Foundation Trust.

The attached report is a draft of the 2013/14 Quality Account for the Stockport NHS Foundation Trust, which sets out the performance of the Trust against a range of priorities.

The Scrutiny Committee is invited to consider the report and  provide feedback.

Contact: Judith Morris, Director of Nursing and Midwifery, 0161 419 5014

The Director of Nursing & Midwifery, Stockport NHS Foundation Trust attended the meeting and submitted a copy of the Trust’s 2013/14 Quality Account (copies of which were circulated) as required by the NHS Regulator, Monitor. The report gave an overview of performance in the past year in relation to quality achievements and improvements in patient care and experience.

The following comments were made/ issues raised:-

·           Ongoing efforts to respond to providing 7-days a week service and improve weekend mortality rates. Current performance in respect of weekend mortality was in line with the average for similar Trusts.

·           Work was ongoing to improve electronic communications and data sharing. This was an ongoing challenge and the Trust recognised its importance. This work was also linked to the Stockport Health Record and Health Plans for those with complex needs.

·           The Trust was working with Care Homes to address problems with dehydration of their residents when being admitted to hospital. The Health & Social Care integration agenda would also address the relationships and challenges with Care Homes.

·           Efforts were continuing to ensure appropriate adult safeguarding training was in place for staff. This was an area for improvement recognised by the Trust.

·           The Trust actively encouraged breast feeding for all mothers, and targeted those from Priority Areas in particular. The Family Nursing Partnership would also provide additional focus on these areas.

·           The targets related to myocardial infarction presented particular challenges as these were based on a bundle of measures. Not meeting one of these measures would lead to a negative result overall, athough this would not mean care was poor overall.

·           There were concerns about the ambiguity of the language in the report relating to complaints and it was suggested this could be improved.

RESOLVED – That the Chair be authorised to provide a formal response to the Stockport NHS Foundation Trust Quality Account 2013/14.

The Chair reported that members of the Scrutiny Committee had earlier used the Wellbeing Kiosk located in Fred Perry House.

The Deputy Director of Public Health reported that the Kiosks, which were located at various places in the borough, tested heart rates and blood pressure and were part of a joint initiative between Public Health and the Clinical Commissioning Group to raise awareness of the dangers of hypertension. It was estimated that 1 in 4 people with hypertension were unaware of their condition.

RESOLVED – That the update be noted.

To consider a report of the Deputy Director of Public Health.

The report provides a brief overview of the current drug and alcohol treatment system, describing areas for development and investigation, and sets out the 3-year strategic aims for the Drug and Alcohol Misuse Strategy 2014/17. This report provides background information to the presentation at agenda item 6.

Officer contact: Alison Leigh, 0161 474 3017, alison.leigh@stockport.gov.uk

Representatives of the Director of Public Health submitted a report (copies of which had been circulated) providing an overview of the current drug and alcohol treatment system, including areas for development, and setting out the strategic aims for the Drug and Alcohol Misuse Strategy 2014/17. The report provided background information to the presentation provided under agenda item 6 (see Minute 8 below).

RESOLVED – That the report be noted.

To consider a presentation from the Drug and Alcohol Directorate Manager, Pennine Care NHS Foundation Trust.

The Drug and Alcohol Dirertorate Manager has been invited to the meeting to discuss the work of the Pennine Care NHS Trust in Stockport in relation to drug and alcohol services.

Contact: Liz McCoy, 0161 716 3666, e.mccoy@nhs.net

Liz McCoy, Drug and Alcohol Directorate Manager and Matthew Phoenix, Stockport Drug and Alcohol Service Manager (Pennine Care NHS Foundation Trust) attended the meeting to provide the Scrutiny Committee with an overview of the work of the Trust’s Drug and Alcohol Service in Stockport. Alison Leigh, Community Safety and Neighbourhoods Manager, and Phil Leigh,Community Safety Operations Manager (Drugs) (Stockport Council) also attended the meeting.

The presentation highlighted the following issues:-

·           The Trust was one of a number of providers of Drug and Alcohol Services in the Stockport area, and worked mostly with those over 25 and with high levels of need.

·           At any one time, there were approximately 600 service misusers of opiates, and 300 dependent alcohol abusers. The turnover of service users was increasing.

·           The Trust also provided harm reduction services, such as needle exchange.

·           There was an emerging problem with non-traditional substances, which was leading to increasingly severe acute medical needs.

·           The Service was moving away from the traditional NHS delivery model, providing aftercare in partnership with other providers, and with the increasing use of former service users as peer supporters.

·           Increasing concerns about older people losing their independence due to medical conditions or falls caused by alcohol and prescription drug abuse. Misusers often developed medical conditions sooner than they would have otherwise.

Councillors asked questions and made comments about the presentation. The following issues were raised:-

·           Prescription drugs were a substance that was often overlooked and not given sufficient weight when developing policies to tackle drug abuse. It was commented that there were examples of older people being overprescribed medication that was subsequently reduced when they were hospitalised. There was a need to ensure GPs were regularly reviewing prescriptions. Medication purchased over the internet was also an increasing cause for concern.

·           The connection between drug and alcohol abuse and loneliness and isolation, particularly in older people, was important to recognise. There was a danger that in a borough like Stockport, the relative affluence could exacerbate the risk of isolation.

·           The involvement of service users in service provision was welcomed and showed significant leadership on the part of the Trust. Those selected were often ex-service users who had previously had severe needs as they would have the greatest insight and would be best placed to understand the wider needs of users and were often able to provide non-clinical support, such as accompanying current users to abstinence meetings. The Payment by Results model helped drive this change by giving greater focus on outcomes and recovery.

·           The Payment by Results model was proving successful for Stockport. There were a range of criteria that determined a positive result for the purposes of the contract, but the Service itself considered a ‘result’ to be a service user being in contact with the service, addressing their wider wellbeing and in a stable lifestyle.

·           There was an increasing problem with non-traditional drugs, such as ‘legal highs’. It was difficult for legislation to stay ahead of these substances, but these were often leading to severe medical conditions and irreversible damage. Diversionary activity was an effective tool to combat this type of substance misuse.

·           Performance enhancing and image enhancing drugs were also becoming a more prevalent problem. Often the effects were hidden because abusers of these substances lived otherwise normal lives and did not conform to the stereotype of a drug-user. They may also not see themselves as drug abusers.

·           There was an opportunity for the Pennine Care NHS Trust and Public Health to collaborate to provide vaccinations for users to prevent avoidable infections.

RESOLVED – (1) That Liz McCoy, Matthew Phoenix, Alison Leigh and Phil Leigh be thanked for their attendance and presentation.

(2) That the Scrutiny Committee welcome the positive work being done to support drug and alcohol misusers to recovery and abstinence, particularly the increasing emphasis on outcomes and the use of former service-users in the co-production of the services.

(3) That  ...  view the full minutes text for item 8.

This item has been placed on the agenda at the request of the Chair.

The Chair will provide a brief update to the Scrutiny Committee in relation to ongoing discussions on the flu vaccination programme for Winter 2014/15.

(NOTE: The Chair was of the opinion that this item, although not included on the agenda, should be considered as a matter of urgency in accordance with Section 100B(4)(b) of the Local Government Act 1972 in order to provide the Scrutiny Committee with an update this matter prior to the end of the current municipal year)

The Chair provided a brief update on discussions taking place between the Council, Clinical Commissioning Group and Public Health England in relation to the flu vaccination programme for the 2014/15 winter period, following concerns raised locally about changes to the 13/14 programme implemented by NHS England with little prior notice to local partners.

The Chair reported that discussions had ceased, and that GP practices were purchasing less vaccine for the 2014/15 period than previously and that there was concern that this would not be sufficient to meet demand and ensure Stockport’s continued high performance in flu vaccinations.

Dr Stephen Watkins (Director of Public Health) and Dr David Baxter (Consultant in Infection Control) attended the meeting and provide a recap of the issues previously discussed at the Scrutiny Committee in relation to the flu vaccination programme.

Dr Watkins and Dr Baxter explained that GP Practices had ordered less vaccine because of the possibility that vaccinations provided at community pharmacies would lead to large stockpiles of unused vaccine. There was concern that the programme being proposed would dis-incentivise GPs and may lead them to terminate programmes early because they would be in direct competition with Community Pharmacies. It was emphasised that there was a place for community pharmacies in the programme, but that the process needed to be organised to recognise the work and effort put in by respective organisations and for remuneration to reflect that.

It was commented that the focus needed to remain on outcomes for residents, and that this point needed to be stressed to NHS England.

It was also commented that although there was very highly performing GP practices in Stockport, there were others where vaccination rates were more in line with Greater Manchester averages, and that this needed to be addressed locally.

RESOLVED – That the update be noted.

To consider a report of the Democratic Services Manager.                                                          

The report sets out planned agenda items for the Scrutiny Committee’s next meeting and Forward Plan items that fall within the remit of the Scrutiny Committee.

The Scrutiny Committee is invited to consider the information in the report and put forward any agenda items for future meetings of the Committee.

Officer contact: Jonathan Vali,   0161 474 3201 , jonathan.vali@stockport.gov.uk

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) setting out planned agenda items for the Scrutiny Committee’s next meeting and any relevant Forward Plan items.

RESOLVED – That the report be noted.