Agenda and minutes

Councillor Paul Bates - Communities

Councillor Stewart Gardiner – Deputy Cabinet Member

Councillor Gordon Baxendale – Visiting member

Dr Tania Stanway –  Cheshire and Wirral partnership

Julia Cottier – Cheshire and Wirral partnership

Sue Redmond – Interim Director of Adult Social Care

Jacki Wilkes – Eastern Cheshire CCG

Mike Moore - NWAS

To approve the minutes of the meeting held on 6 July 2016.

RESOLVED – That the minutes of the meeting held on 7 July be confirmed as a correct record and signed by the Chairman.

To provide an opportunity for Members and Officers to declare any disclosable pecuniary and non-pecuniary interests in any item on the agenda.

There were no declarations of interest.

To provide an opportunity for Members to declare the existence of a party whip in relation to any item on the Agenda

There were no declarations of the existence of a party whip.

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 and 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 speak.

To review response to the NWAS Ambulance Service Review (report to follow)

The Committee considered a report of the Director of Legal Services and Monitoring Officer relating to responses received in connection with a review of North West Ambulance Services (NWAS) carried out on 19 February 2016 and 24 March 2016.

On 19 February 2016, the Committee had undertaken a full day spotlight review of NWAS. The committee interviewed a variety of stakeholders about how their organisation contributed towards ambulance services, what they considered were the future challenges for services and what initiatives might contribute towards making improvements to performance and provide better outcomes for patients in Cheshire East.

The meeting held on 19 February 2016 was used as a ‘fact finding’ day and adjourned for a further half day session on 24 March 2016, when the Committee received additional information and discussed its conclusions and recommendations The committee had published its findings, conclusions and recommendations in a formal report on 29 April 2016. Participants in the process had been invited to respond to the recommendations by Friday 19 August 2016.

The committee considered responses from:

·         Department of Health;

·         NWAS;

·         Interim Director of Adult Social Care and Independent Living;

·         Healthwatch;

·         Eastern Cheshire and South Cheshire CCGs

·          

On behalf of NWAS, Mike Moore referred to a national pilot scheme called ‘Dispatch on Disposition’ which was a new way for ambulance services to respond to 999 calls. The new way of dispatching had a number of objectives including:

·         Reduction in the number of inappropriate ambulance responses by increasing the percentage of patients treated by telephone advice;

·          Improved accuracy of triage of ambulance incidents, ensuring the most appropriate and timely response to meet the patients clinical needs;

·         Improved response to the most critical, life-threatening ambulance incidents (Red 1 incidents)

·         Improvements in performance against the ambulance response time targets.

The changes to the dispatch process did not apply to incidents identified as immediately life-threatening (Red 1 incidents), where an ambulance would continue to be dispatched immediately. The process related to non-Red 1 incidents, whereby patients would be triaged over the telephone before dispatching an ambulance. The additional time spent on the telephone provided an opportunity to identify the most appropriate response which in some cases may not be an ambulance.

It was expected that from October 2016, the ‘Dispatch on Disposition’ system could be used in the North West.

In response to a question about how the inequity between Rural and Urban areas could be addressed over a large area like the North West region, Mike reminded the committee that although all CCGs across the region commissioned Ambulance Services, Blackpool CCG took the lead on behalf of all North West CCGs.

As of 1 September 2016, System Delivery Groups had been replaced by A&E Delivery boards whose role would be to influence quality initiatives. The main priority for the delivery boards had been to achieve a reduction in conveyance by ambulance and an improvement in performance through, for example, better triage arrangements on a Cheshire/ Wirral footprint.

In response to a question about whether  ...  view the full minutes text for item 15.

To consider a report of Cheshire and Wirral Partnership NHS Foundation Trust (CWP)

Councillor Gordon Baxendale attended the meeting and addressed the committee in respect of this matter.

Julia Cottier, Cheshire and Wirral Partnership CWP Service Director for Central and Eastern Cheshire and Dr Tania Stanway, CWP Clinical Director and Consultant Psychiatrist attended the meeting and presented a report setting out proposals to re-design Adult and Older Peoples Mental Health Services in Cheshire East.

The report gave details of two delivery options which were being proposed to go forward to a formal consultation process. The two options involved:

Option 1 - Sustain inpatient care at current levels through a reduction in community mental health services

Option 2 - Enhance community mental health services so that more people can receive care closer to home and improve quality of inpatient provision by providing inpatient care from other existing purpose built sites.

CWP’s preferred option was option 2. CWP suggested that a review of how these services could be provided in future had indicated that they could be provided in this way if further targeted investment was made in community services, and the implementation of new ways of working which had seen effective reductions in admissions and length of stay elsewhere in the Trust.

In response to questions about the commencement of the formal consultation period on the proposal and whether authorities at Cheshire West and Chester and Wirral would also be involved in the consultation process, the committee expressed a view that further information would be required to enable the committee to determine this matter.

RESOLVED

(a)   That consideration of this matter be deferred to the 6 October meeting;

(b)  That in the meantime, the Scrutiny manager be requested to ascertain from colleagues in Cheshire West and Chester and Wirral whether the matter is likely to be treated as a Substantial Variation or Development by the respective Health Scrutiny Committees in those Councils;

(c)  That CWP be requested to report back to the 6 October meeting with additional details of the number of patients likely to be affected by the proposals, current waiting times, and the impact on the service of the potential reduction in available beds.

Eastern Cheshire CCG to provide an update.

RESOLVED – That consideration of this matter be deferred.

To consider a revised protocol.

The Committee considered a revised Overview and Scrutiny Protocol which had been amended to accurately reflect the name of this committee and to take account of consequential minor amendments resulting from the Health and Adult Social Care Act 2012.

RESOLVED – That the revised protocol be approved.

To review the current Work Programme

The Committee reviewed its work programme.

RESOLVED – That the work programme be approved: