Agenda and minutes

Apologies for absence were received from Councillors G Boston, M Hardy, D Hough and A Martin.

Councillor M Grant, member of the Committee

Councillor G Merry, member of the Committee

Councillor D Flude, substitute for Councillor G Bolton

Councillor B Silvester, substitute for Councillor A Martin

Councillor R Domleo, Cabinet Member for Adult Services; Cabinet Member for Health and Wellbeing (interim)

Councillor J Clowes, Cabinet Support Member for Health and Wellbeing

G Kilminster, Head of Health and Wellbeing, Cheshire East Council

L Scally, Head of Strategic Commissioning and Safeguarding, Cheshire East Council

H Grimbaldeston, Director of Public Health, Central and Eastern Cheshire Primary Care Trust (CECPCT)

F Field, Director of Governance and Strategic Planning, CECPCT

D J French, Scrutiny Officer

J Hawker, Clinical Commissioning Group (East Cheshire)

S Whitehouse, Clinical Commissioning Group (South Cheshire)

L Nolan, East Cheshire NHS Trust

To provide an opportunity for Members and Officers to declare any personal and/or prejudicial interests and for members to declare the existence of a party whip in relation to any item on the agenda.

None

To approve the minutes of the meeting held on 9 June 2011.

RESOLVED:  That the minutes of the meeting of the Committee held on 9 June be confirmed as a correct record.

A total period of 15 minutes is allocated for members of the public to make a statement(s) on any matter that falls within the remit of the Committee.

Individual members of the public may speak for up to 5 minutes, but the Chairman will decide how the period of time allocated for public speaking will be apportioned, where there are a number of speakers.

Note: in order for officers to undertake any background research, it would be helpful if members of the public notified the Scrutiny officer listed at the foot of the agenda at least one working day before the meeting with brief details of the matter to be covered.

There were no members of the public present who wished to address the Committee.

To receive verbal updates on the role and development of Commissioning Consortia in Cheshire East.

The Chairman welcomed Simon Whitehouse and Jerry Hawker who were attending to talk about progress with establishing GP Commissioning Consortia in Cheshire East; it was explained that these bodies were now known as Clinical Commissioning Groups (CCG).  In Cheshire there were 4 Groups to be known as West, Vale Royal, South and East.  A map was circulated showing the boundaries of the Groups and the Local Authority boundaries.  The majority of the population of Cheshire East would fall within the South or East Groups. Although the Health and Social Care Bill was currently going through parliament, work could still continue to manage the transition process from the Primary Care Trust to the CCGs.

Simon Whitehouse explained that the South Cheshire Clinical Commissioning Group (CCG) included 16 GP practices and covered Nantwich, Crewe, Alsager and Sandbach and surrounding areas.  At the moment the focus was on maintaining services, developing financial arrangements, building relationships and ensuring good engagement practices were developed.  As part of the engagement process, a Question Time event had been held with the Local Involvement Network (LINk) on 26 July.

Jerry Hawker outlined the position with the East Cheshire Clinical Commissioning Consortia which had 22 GP Practices and a population of around 202,000 people.  To date, work had been carried out on building relationships with the main acute providers including East Cheshire Hospital Trust as well as providers in Manchester and Stockport and developing relationships with the local population; a meeting had been held with the LINk and a Patient Forum was under development.  The Board included a Lay Member and a Nurse.  One of the challenges for the Consortia was the ageing population and management of long term conditions.

During discussion of the item the following points were raised:

      The Commissioning Groups had now been running for almost a year and were based on the former practice based commissioning groups;

      Staffing issues were still to be resolved as the earliest the CCGs could become statutory bodies would be October 2012, although it was likely to be April 2013, therefore staff could not currently be directly employed;

      It was noted that the PCT had previously been overspent but had managed to reduce its debt and Members asked about the current position?  In response, the Committee was advised that at Quarter 1 the PCT was forecasting a balanced position but nevertheless the local health economy was still in a challenging financial position overall.  The Acute Trust and PCT were working closely together to manage financial pressures;

      In relation to Mental Health, it was noted that improvements had been made by the PCT compared with the position it had inherited in 2006.  It was a challenge that there was no in-patient provision in the South Cheshire CCG area, however the Group would continue to work with Cheshire and Wirral Partnership NHS foundation Trust (CWP), the provider of mental health services in the area;

      In relation to the transfer of community services to the East Cheshire Hospital Trust, it was  ...  view the full minutes text for item 20.

To consider the report of Lesley Petrie, East Cheshire Hospital Trust.

The Committee considered a report of East Cheshire NHS Trust on proposed changes to the provision of the Minor Injuries Unit at Congleton War Memorial Hospital. 

The proposal related to an alteration to the opening times of the Unit; it was proposed that the opening hours be reduced and an Emergency Nurse Practitioner be employed each day to mainly treat minor injuries patients and a Health Care Assistant be employed, for half a day, to deal with most of the GP referral patients.  This option would remove the risk related to lone working as a radiographer would work at the Unit during the morning. 

The Unit’s current opening hours were from 8.30 am until 8.30 pm but the number of patients attending with minor injuries was low and patients mainly attended between 10.00am – 4.00 pm.  It was proposed that the weekday hours be amended to 10.00 am – 6.00pm and the weekend and Bank Holiday hours remain as 8.00 am – 8.30pm.  Consultation had been carried out with the Ambulance Trust, local GP surgeries and the Local Involvement Network.

RESOLVED: That the proposed changes to the opening times of the Minor Injuries Unit, as set out in the report, be supported. 

Barrie Towse, Cheshire East LINk Chair and Neil Garbett, Team Leader of the LINk support team, will present the Annual Report.

Copies of the Annual Report are enclosed.

Barrie Towse, Chair of the Cheshire East Local Involvement Network (LINk), presented the Annual Report. 

The report outlined the structure and membership of the LINk and detailed the work carried out over the year, including:

      Enter and View – the LINk had a statutory right to Enter and View Health and Social Care facilities to ensure that they complied with essential standards set by the Care Quality Commission.  A number of such visits had been undertaken including a number of unannounced visits, including to 2 Emergency Departments, 1 Elderly Care Ward (which had been unannounced) and to 2 Learning Disability facilities.  The notice when undertaking visits was anything up to 15 days.  It was sometimes helpful to give a short period of notice as this would enable the manager to make sure they were available;

      The Mental Health Sub Group had undertaken work with CWP, the provider trust, and been involved with a number of consultations on service changes;

      Hospital discharges and readmissions – the LINk had listened to patient experiences and sought views on the local radio.  Discussions had been held with both Acute Trusts on discharges and readmissions, and the East Cheshire Hospital Trust had introduced Patient’s Passport to try to identify those at risk of readmission;

      Communications – a Sub Group had been formed to look at improving communications and had commissioned an advertising campaign on the local radio as well as reviewing the website;

      Social Care – work in this area had included a one day conference at Crewe Alexandra Football Club on Demystifying Personalisation which had been attended by over 100 delegates; following the success of this event, 2 workshop events had been held in Knutsford and Congleton.

The LINk had developed constructive relationships with a number of partners through Joint Liaison Meetings which were seen as a successful initiative; these were monthly meetings with representation from a wide variety of organisations including the Primary Care Trust, GP Consortia, Council for Voluntary Services and Local Authority.  The LINk attended the Overview and Scrutiny Committee meetings and representatives welcomed the opportunity to contribute. 

Neil Garbett, the Support Team Leader, explained the role of the Support Team. The role had been refocused due to staff changes and close working arrangements had been developed with a number of organisations.  Training had been held for members especially in relation to Enter and View.  The LINk had also applied for Pathfinder Status and was waiting to hear the outcome.  There was still uncertainty around future funding.  Lucia Scally explained that there was uncertainty from central Government around the future funding of Healthwatch but some transitional funding had been made available from the Adult Social Care budget.

Members discussed the Annual report and made the following points:

      The LINk were to be congratulated on their work and their report which was an excellent in-house production;

      The hard work of the LINk members, who were all volunteers, was to be commended;

      It was suggested that a short introduction to the Report on  ...  view the full minutes text for item 22.

To review the current Work Programme (attached).

The Committee considered its Work Programme which had been reviewed and updated by the Chairman and Vice Chairman, together with the Scrutiny Officer. 

The Committee was advised of the proposed timetable for setting the Work Programme, as agreed at the Scrutiny Chairman’s Group.  It was proposed that 1:1 meetings with Portfolio Holders take place between the Scrutiny Chairman and Vice Chairman and Portfolio Holder, this would enable the Portfolio Holder to highlight any future issues.  It was then proposed that an informal meeting of the Committee take place to give detailed consideration to items raised at these 1:1 meetings, together with items on the existing Work Programme and any items raised by members.

This would then enable a Work Programme to be formulated for discussion with Corporate Management Team (CMT) and Cabinet around Autumn.  The intention behind involving CMT and Cabinet in a two way process to formulate the majority of the work programme was to ensure that resources were made available to Overview and Scrutiny Committees from Service Heads to complete reviews and to enable the committees to focus on Corporate priorities.

An issue had also been referred from the Children and Families Scrutiny Committee in relation to health and Cared for Children; this had arisen during a Scrutiny Review on Fostering Services.   Councillor Flude, who had chaired the Scrutiny Review, outlined the findings and why it was felt that some scrutiny work specifically on health and cared for children would be useful.

RESOLVED:  that

(a) an informal meeting of the Committee be held on Thursday 8 September at 10.00 am to enable Members to give full consideration to the Committee’s Work Programme, with support from all relevant officers; and

(b) a report on the main issues in relation to health and Cared for Children be submitted to the Scrutiny Chairmen’s Group for initial consideration and agreement as to how to progress the issue.

To consider extracts of the Forward Plan that fall within the remit of the Committee (attached).

Note: both items in the Forward Plan extract are listed with Corporate Scrutiny Committee as the relevant Scrutiny Committee.  However, this is based on previous Scrutiny Committee remits.  At the Council meeting on 21 July, a recommendation from Constitution Committee will be considered on Overview and Scrutiny Committee’s Terms of Reference that proposes that this Committee will scrutinise the operational delivery of leisure and cultural services.  The former Corporate Scrutiny Committee has undertaken some scrutiny work of both these issues.

The Committee considered extracts of the Forward Plan insofar as they related to its work.  Following approval of the Scrutiny Committee remits at full Council on 21 July, there were two issues on the Plan that were now relevant to this Committee’s work – “Future operation of Knutsford Cinema” and “Future operation of Crewe Lyceum Theatre”.  Both items had previously been considered by the Corporate Scrutiny Committee.  The Committee received an update on the current position as follows:

      Knutsford Cinema – an advert was to be published the first week of August to invite bidders to run the cinema within the Civic Centre with a 6 week response period.  Bids would be evaluated in September and a preferred option taken to full Cabinet in October or November;

      Crewe Theatre – soft market testing was being undertaken to establish likely levels of interest from commercial operators or community enterprises.  This would be completed around the end of August and outcomes shared with the Portfolio Holder and the next steps agreed.

RESOLVED:  that the update on Knutsford Cinema and Crewe Theatre be noted.

To note any consultations referred to the Committee from Cabinet and to determine whether any further action is appropriate.

There were no consultations from Cabinet.