Agenda and minutes

To approve as a correct record and sign the Minutes of the meeting held on 24 February 2015.

The Minutes (copies of which had been circulated) of the meeting held on 24 February 2015 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

To consider call-in items (if any).

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 2014/15 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

Judith Morris, the Director of Nursing & Midwifery, Stockport NHS Foundation Trust attended the meeting and submitted a copy of the Trust’s 2014/15 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.

In relation to those areas for improvement identified in 2013/14 Quality Account, the following update was provided:-

·         The Trust had improved its mechanisms for gaining feedback from patients, such as post-discharge surveys, the use of SMS surveys etc.

·         The Trust had implemented the FAIR (Find, Assess and Investigate, Refer) procedure to improve the diagnosis of those with dementia who accessed the Trust’s services. Ensuring appropriate nursing care to those with dementia was also a priority for the Trust.

·         The identification of carers had also been improved. A Carer’s Information Point had also been provided within the hospital.

·         Improvements had been made in the procedures for the identification and flagging for non-elective attendance by those with learning disabilities and who may have additional needs. Additional investment had also been made in adult safeguarding to provide expert advice and guidance to the Trust’s staff.

·         Communications had also improved, particularly in relation to communication in medical wards and working in partnership with staff. Complaints in relation to communications had reduced by 50% in the last year.

The following comments were made/ issues raised:-

·         Improvements in communications were welcomed as concerns had been raised at this Scrutiny Committee previously.

·         Queries were raised in relation to performance on infection control. Performance in relation to C Difficile had improved, although MRSA rates had increased. It was commented that additional measures had been put in place to address poor performance on C Diff infections, such as increased frequency of testing. MSRA performance was disappointing but reflected the increased frequency of intravenous activity.

·         Concerns were expressed about the reductions in access to breast milk for premature babies and the potential impact on breast feeding support as a result of changes to the Council’s commissioning strategies. It was commented that staff at the Trust were well trained in promoting breast feeding and its benefits and the work done by both staff and volunteers was to be commended. It was also confirmed that the Trust did not allow the promotion of milk formula products in the hospital.

·         The introduction of 7 day a week stroke service was welcomed.

·         Members welcomed the openness and engagement with the Trust.

Additional comments were made in relation to the following:-

·         Improvements in patient experience, in particular in relation to falls. It was commented that the Trust continued to work to reduce falls in the hospital and looked for innovative solutions.

·         Concerns about rates of satisfaction amongst staff and the mechanisms for monitoring this. It was commented that the Trust now collected this data on a quarterly basis. Staff satisfaction at the Stockport NHS Foundation Trust compared favourably to other NHS Trusts.

·         The loss of patient notes. It was commented that this was relatively infrequent but the development of an electronic record would make a significant contribution to reducing the likelihood of this occurring.

·         Reporting of weekend mortality no longer appearing in the Quality Account. It was confirmed that this was monitored but now formed part of a separate reporting process relating to 24/7 working.

RESOLVED – (1) That the Draft Stockport NHS Foundation Trust Quality Account 2014/15 be noted and welcomed.

(2) That the Chair be authorised to provide a formal response to the Stockport NHS Foundation Trust Quality Account 2014/15.

At the meeting on 20 January 2015, the Scrutiny Committee considered a report from Public Health England on the link between mortality and air pollution, and resolved that “the Director of Public Health be requested to submit a report to a future meeting on the impact of particulate air pollution on health and mortality in Stockport”.

Representative of Public Health, Environment Health and Transportation Policy will attend the meeting to provide an ‘expert panel’ to respond to questions from the Committee on air pollution and health.

At the meeting on 20 January 2015, the Scrutiny Committee considered a report from Public Health England on the link between mortality and air pollution, and resolved that “the Director of Public Health be requested to submit a report to a future meeting on the impact of particulate air pollution on health and mortality in Stockport”.

Donna Sager (Deputy Director of Public Health), Ian O’Donnell (Head of Public Protection) and Sue Stevenson (Investing in Growth Manager) attended the meeting to provide an ‘expert panel’ to respond to questions from the Scrutiny Committee on air pollution and health.

The ‘Panel’ provided some additional background information to inform the discussion. This included:-

·         There had been significant improvements in air quality in the UK during the last century, due to a range of legislative changes; changes in fuel usage and changes/ reductions in industrial processes.

·         Air pollution impacted mortality and morbidity, particularly in relation to respiratory factors and impacted most those who were young, old and those with complex conditions.

·         Transportation now contributed the greatest proportion of particulates that made up air pollution. Nationally there had been action to improve engine and fuel quality, although uncertainty remained about the impact of these changes. Efforts to reduce CO2 emissions from vehicles lead to an increase use of diesel that had a negative impact on air pollution because of the particulates released by its use.

·         There was a national Air Quality Strategy, published in March 2011 that set out air quality objectives and policy options to further improve air quality in the UK. As well as direct benefits to public health, these options were intended to provide important benefits to quality of life and help to protect the environment.

·         There was a local and Greater Manchester Air Quality Action Plan that was based on predictive modelling of air pollution, and sought to arrest the increase in particulate levels.

·         Locally, the Council participated in work at a Greater Manchester level to improve air quality, most notably through work to improve transport links, particularly public transport and alternatives modes of travel such as cycling and walking. Reducing congestion would reduce the emissions from cars and other motor vehicles.

·         The Public Protection Service was involved in a range of activities to ensure air pollution was minimised, including the monitoring of economic and industrial activities; taxi vehicles and air quality monitoring. Stockport monitored Nitrogen Oxide levels at various sites, and there was a ‘real time’ monitoring station in Hazel Grove on the A6, data from which was available at www.greaterairmanchester.org.uk.

·         Overall, levels of air pollution in Stockport were comparable to the levels in other parts of Greater Manchester.

·         Following the fire at the ‘Junction 25’ Recycling Centre in Bredbury in August 2013 the Council and other partners put in additional air quality monitoring in the vicinity.

Councillors asked questions and made comments. The issues raised included:-

·         The reduction in industrial activity and emissions and the increase in transportation emissions had changed the pattern of air pollution, which was now concentrated in areas that mapped onto the road network. There was a high concentration of particulates within 10 metres of a busy road, but this halved for every 10 metres further from the road, and varied depending on levels of congestion. Vehicles stopping and starting, and drivers idling their engines would cause particulate levels to increase. Traffic congestion was often worst along built up residential areas and near schools where houses were within 10 metres of the road. The effect would be intensified in confined streets or environments.

·         In comparison to road traffic, particulate levels from aircraft were of marginal impact to overall air quality. Even in Stockport where air craft were descending the relative height and speed of the aircraft meant that particulates were dispersed relatively quickly so as to minimise the impact on air quality in any given location. Nevertheless, the Council had regular meeting with Manchester  ...  view the full minutes text for item 5.

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

The Department of Health is currently consulting on a range of measure to support people with learning disabilities, autism and mental health conditions live independent lives and empower them and their carers in making choices about their care, building on a range of previous legislation.

The scope of the consultation primarily relates to:

(i)    assessment and treatment in mental health hospitals for people (all age) with learning disability or autism;

(ii)   adult care and support, primarily for those with learning disability but also for adults with autism (and the links to support for children and young people); and

(iii) those to whom those Mental Health Act currently applies (including children and young people).

The Consultation Document poses a series of questions for responders to consider.

The Committee is invited to consider the consultation document and to decide whether or not it wishes to respond to the consultation.

Officer contact: Karen Kime, 0161 474 3574, karen.kime@stockport.gov.uk

A representative of the Democratic Services Manager reported that this item had been placed on the agenda at the request of the Chair.

The Chair reported on the recent publication by the Department of Health of a consultation entitled ‘'No voice unheard, no right ignored’ on a range of possible measures to support people with learning disabilities, autism and mental health conditions to live independent lives. The Chair invited the Scrutiny Committee to consider whether or not to respond to the consultation.

The following comments were made/ issues raised:-

·         The Scrutiny Committee had given much consideration to mental health previously so was well placed to make a contribution to the consultation.

·         Locally, partners were engaged in work to promote independent living and to support those with mental health problems.

·         Any response should stress the role of employment in encouraging independence for those with autism.

·         There was a distinction between the potentially lifelong need of some with autism and the potentially intermittent support needed for those with a mental health issue.

RESOLVED – That the Democratic Services Manager, in consultation with the Chair, be requested to prepare a response to the consultation 'No voice unheard, no right ignored – a consultation for people with learning disabilities, autism and mental health conditions' based on the work previously undertaken by the Scrutiny Committee and to circulate this response to members prior to its submission.

To consider the Public Health England Health Profile for Stockport for 2014 published in February 2015.

The Scrutiny Committee is invited to consider the Profile and identify any areas for further discussion.

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

A representative of the Democratic Services Manager submitted the 2014 Public Health England Health Profile for Stockport (copies of which had been circulated). The Chair invited the Scrutiny Committee to consider the Profile and identify any areas for further consideration.

It was suggested that obesity was an area that should be kept under consideration for future discussion.

RESOLVED – That the Stockport Health Profile 2014 be noted.

To consider an update from the Chair on further development with the referral from Healthwatch Stockport to the Secretary of State raising concerns about possible reconfigurations to mental health services in Stockport.

The Chair updated the Scrutiny Committee in relation to a letter sent by Healthwatch Stockport to the Minister of State for Care and Support raising concerns about the perceived lack of public consultation on the proposals for changes to mental health services announced by Pennine Care NHS Foundation Trust (Minute 6 of 24 February 2015 refers).

The Chair reported that since the last Scrutiny Committee meeting he had met with senior management of Pennine Care NHS Foundation Trust to discuss the concerns raised by the Healthwatch Stockport, who had also planned to meet the Minister of State. The matter had also been raised at the Joint Scrutiny Committee for Pennine Care.

The Chair was aware that a response had been sent to Healthwatch from the Minister and that when a copy was made available to him the Chair would ensure it was circulated to members of the Scrutiny Committee.

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 next two meetings and any relevant Forward Plan items.

The Chair thanked councillors and officers for their contribution to the Scrutiny Committee during 2014/15.

RESOLVED – That the report be noted.