Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 10 September 2013.

The Minutes (copies of which had been circulated) of the meeting held on 10 September 2013 were approved as a correct record and signed by the Chair.

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

The following interests were declared:-

Personal Interests

There were no call-ins to consider.

To consider a presentation from the Chief Executive and Director of Operations, Stockport NHS Foundation Trust.

Following on from the presentation made to the Scrutiny Committee in July 2013, this presentation will provide an update to the Committee on the actions taken by the Trust to address performance against the 4 hour target for unplanned admissions.

Details of the previous meeting at which this matter was considered can be found at http://democracy.stockport.gov.uk/ieListDocuments.aspx?CId=153&MId=5322&Ver=4

Ann Barnes (Chief Executive) and James Sumner (Chief Operating Officer), Stockport NHS Foundation Trust, attended the meeting and provided an update on progress with implementing the Trust’s action plan to address performance against the 4-hour target for unplanned hospital admissions. A copy of a briefing report was also submitted (copies of which were circulated).

The update provided background information to the reduction in performance in the previous year that had prompted the involvement of Monitor, the NHS Regulator, and highlighted actions taken by the Trust since the last update made to the Scrutiny Committee in July 2013.

The following issues were highlighted:-

·         Performance against the 95% target had improved and the Trust had achieved the standard for the preceding two months and was currently above the target level for October up to the date of the meeting.

·         The eight point plan agreed with Monitor had been delivered, with the exception of the recruitment of Emergency Department (ED) consultants where repeated attempts had proven unsuccessful. Recruitment of these consultants, as well as middle grade doctors, remained a challenge.

·         New services had been introduced including the Ambulatory Care Unit, a pathfinder project with the North West Ambulance Service, and IV Therapy Pilot, put in place to ensure those who did not need to be admitted were kept out of hospital.

·         The additional Winter Pressures resources would be targeted to those areas of highest need in collaboration with the Clinical Commissioning Group (CCG).

The following comments were made/ issues raised:-

·         Difficulties in recruitment reflected a national trend. Plans were in place to recruit to other posts/levels to support and supplement the expertise already in place. Expanding the number of Nurse Practioners through training of existing staff was being undertaken.

·         The allocation of the £1.5m of extra, non-recurrent A&E monies was to support projects that would realise savings elsewhere in the system. Many of these projects were genuinely innovative. One of the projects was to provide additional support to target repeat attendance caused by or related to alcohol.

·         Addressing dangerous alcohol consumption was complex and required changing ingrained patterns of behaviour. This was not necessarily most appropriately done in a hospital setting.

·         There was an excessive dependence on hospital care in Stockport and this would have to change in the future as it was unsustainable and unaffordable. Greater emphasis on prevention and community delivery was needed. Encouraging the public to use the most appropriate services was continuing.

·         There was a danger of patients becoming lonely and isolated if more care was provided at home. This was being considered as part of the work on health and social care integration and Stockport One.

·         The project with the North West Ambulance Service, to try to ensure only emergencies were brought to hospital, had been very successful so far although further work was needed to verify the data. It was not yet possible to identify how many patients may later have been admitted. The pilot demonstrated the efficacy of the work of the Ambulance Service in deflecting non-emergencies but also highlighted the willingness of the public to call an ambulance for GP-manageable conditions or even for inappropriate issues.

·         Out of hours care was key to the overall approach to reducing hospital admissions and A&E attendances, but patients often felt unsure about the treatment so were not able to make the right choices when they needed assistance. The cost of the alternatives to this service meant that it had to be given the opportunity to succeed.

·         Phase 2 of the work to address unplanned admissions was to try to quantify the number of admissions could have been more appropriately dealt with in other ways, outside of the hospital setting, to ensure the right care was provided.

RESOLVED – (1) That Ann Barnes and James Sumner be thanked for their attendance and presentation.

(2) That the Chief Executive, Stockport NHS Foundation Trust be invited to provide  ...  view the full minutes text for item 4.

Enclosed are two health profiles for Stockport, one on general health indicators and the other on mental health.

The Scrutiny Committee is invited to consider the profiles and highlight any issues for further consideration at future meetings.

To consider a report of Public Health England.

Enclosed in the agenda is a copy of the Health Profile for Stockport for 2013 produced by Public Health England which aims to give a picture of health in the area.

A representative of the Democratic Services Manager submitted the 2013 Health Profile for Stockport (copies of which had been circulated) produced by Public Health England.

The following comments were made/ issues raised:-

·         Additional midwife capacity had been provided to support efforts to reduce smoking in pregnancy, as well as the appointment of a breastfeeding champion to provide greater emphasis within the community setting. The re-introduction of the Nursing Partnership in 2014 should also help with these efforts.

·         There remained a persistently high level of diagnosis of malignant melanoma. The higher prevalence may also reflect better screening in Stockport. Of the 52 cases in the previous year 10 individuals had died, and all were preventable deaths.

·         Significant efforts were being made to educate young people about the dangers of alcohol and it was highly unlikely that most young people were not aware of these messages, but translating this into behavioural change remained a challenge given the ready availability of alcohol.

RESOLVED – (1) The report be noted.

(2) That the Director of Public Health be requested to provide a future meeting of the Scrutiny Committee with additional information on rates of early death from cancer, smoking in pregnancy and the gender profile of those being diagnosed with malignant melanoma.

To consider a report of the Public Health Observatories in England.

Enclosed is a copy of the Community Mental Health Profiles (CMHP) which present a range of mental health information for local authorities in England. The CMHP are designed to give an overview of mental health risks, prevalence and services at a local, regional and national level.

A representative of the Democratic Services Manager submitted the 2013 Community Mental Health Profile for Stockport (copies of which had been circulated) produced by the Network of Public Health Observatories.

Councillors commented on the marked differences in certain mental health outcomes between the North and South of England, as well as the marked differences in rates of prevalence for particular disorders and access to services between Stockport and neighbouring authorities.

RESOLVED – That the report 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 future meetings and any relevant Forward Plan items.

RESOLVED – That the report be noted.