Agenda and minutes

To note any apologies for absence from Members.

Apologies for absence were received from Councillors John Smith, Julie Smith and Brian Drake.

Councillor Dawn Clarke was present as substitute.

Discussion took place about the potential for some Councillors to regularly offer apologies for absence from Scrutiny Committee meetings, which was a matter of concern to Committee members. There was consensus from the Committee that the Head of Democratic Services and Governance, in consultation with the Group Administrators, should give consideration to this in order to identify a suitable solution.

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

In the interests of openness, in relation to agenda item 6 (Quality Account 2022-23 Cheshire and Wirral Partnership NHS Foundation Trust) Councillor Wardlaw declared that she occasionally worked for the Cheshire and Wirral Partnership NHS Foundation Trust.

In the interests of openness, Councillor Seddon declared that she worked in an office-based role for AstraZeneca, a pharmaceutical company based in Cheshire East.

To approve as a correct record the minutes of the previous meeting held on Thursday 16 March 2023.

RESOLVED:

That the minutes of the meeting held on Thursday 16 March 2023 be approved as a correct record and signed by the Chair.

There is no facility to allow questions by members of the public at meetings of the Scrutiny Committee. However, a period of 10 minutes will be provided at the beginning of such meetings to allow members of the public to make a statement on any matter that falls within the remit of the committee, subject to individual speakers being restricted to 3 minutes.

There were no members of the public registered to speak.

For the Committee to provide commentary on the Mid Cheshire Hospitals NHS Foundation Trust Quality Account 2022-23.

Laura Egerton, Deputy Chief Nursing Officer and Laura McVeigh, Head of Nursing, Engagement & Wellbeing attended the Committee meeting and delivered a presentation which provided an overview of the key challenges and achievements outlined within the Mid Cheshire Hospitals NHS Foundation Trust Quality Account 2022-23. It was highlighted that the Coronavirus Pandemic recovery remained a key challenge for the Trust during 2022-23 however there were a number of achievements that had been celebrated and referred to within the Quality Account 2022-23.

The Committee noted that the Central Cheshire Integrated Care Partnership had introduced Urgent Crisis Response into the community which enabled patients to have access to care from Therapists and Advanced Clinical Practitioners 8am-8pm 7 days a week. It was reported that the impact on staff deployment and wellbeing had been minimal as a result of additional investment into the service, recruiting an additional six FTEs to ensure a 7-day service could be appropriately staffed. It was reported that the Trust was in a positive position in relation to its overall staffing levels with a significant cohort of students taking up positions in September 2023. It was noted that the Trust anticipated that it would have no vacancies from September 2023.

It was reported that during 2022-23 the Trust launched an Improvement Matters Strategy to provide a structured approach to problem-solving and a clear and consistent framework for all improvement activity. It was noted that over 600 staff and patients were engaged in the development of the vision for quality and improvement aims. The Committee queried the percentage of staff engaged versus the percentage of patients and how this was undertaken. Laura Egerton committed to providing a written response.

The Committee noted the steps taken by the Trust to demonstrate its commitment to Dementia care and the support in place for patients with Dementia who were admitted to hospital. The Committee was pleased to learn that the Trust had specialist support in place (Head of Nursing for Adult Safeguarding and a Dementia Care Specialist Nurse) and that there was a specific pathway in place for patients with Dementia which was tailored to the individual patients needs in consultation with relatives. The Committee queried how the Dementia pathway was conveyed back to GPs, carers and the wider community. Laura Egerton committed to providing a written response.

The Committee was pleased to learn of the additional steps being taken by the Trust to improve the End-of-Life Service. It was confirmed that the Trust was working closely with the End-of-Life Partnership and progressing to implement the SWAN model, used to support and guide the care of patients and their loved ones during end-of-life care, and afterwards. The Committee queried what the five priorities for End-of-Life Care were, as referred to within the Quality Account 2022-23. Laura Egerton committed to providing a written response. 

The Committee referred to the ongoing NHS backlog issues and requested that an update on waiting times be provided by the Trust. Laura Egerton committed to following this up with operational  ...  view the full minutes text for item 5.

For the Committee to provide commentary on the Cheshire and Wirral Partnership NHS Foundation Trust Quality Account 2022-23.

Maddy Lowry, Associate Director Cheshire East attended the Committee meeting and delivered a presentation which provided an overview of the key challenges and achievements outlined within the Cheshire and Wirral Partnership NHS Foundation Trust Quality Account 2022-23. The Committee noted the wide range of services provided by the Trust throughout 2022-23 and its key achievements and challenges. The Committee was pleased to learn that the Care Quality Commission had rated the Trust ‘Good’ overall with ‘Outstanding’ for caring and ‘Good’ for all other key requirements (safe, effective, responsive and well-led).

An update was provided on two new mental health crisis cafes which were opened in February 2022 in Crewe and Macclesfield. The Committee was pleased to hear how these cafes had formed a vital part of improving experience of urgent mental health support and queried what additional steps the Trust could take to assist more individuals from the wider community in travelling to the crisis cafes in Crewe and Macclesfield – particularly in the evening when there were no bus services available. Maddy Lowry committed to feedback the helpful suggestion from Committee and investigate this further.

It was reported that the Trust approved its Autism Strategy in May 2022, which was developed through co-production with autistic people, their families/carers, partners and CWP staff. The Committee noted that 7 in 10 autistic adults would experience a mental health episode during their lifetime and that a priority for the Trust was to make its services as accessible as possible particularly for individuals with neurodevelopmental needs who struggled to engage with services. The Committee welcomed the opportunity to learn more about the Strategy, its implementation, staffing requirements and dissemination into the wider community.

The Committee noted the steps being taken by the Trust to introduce more mental health services within local communities and were pleased to learn that the Trust had been recognised as an overall top performer following the publication of results from the Care Quality Commission following a survey of mental health community services. The Committee asked what support was available for families and patients in crisis and noted that the Trust had launched a ‘First Response Service’ which provided urgent mental health support by improving access to services for people experiencing mental health crisis and ensuring care was provided by the right person, in the right place, at the right time.

The Committee noted the mental health support services available to children and young people and queried how demand would be managed. It was reported that additional investment had been put into the service and a significant amount of work had been undertaken to streamline pathways to ensure that patients received one holistic assessment and diagnosis to improve patient experience and waiting times.

RESOLVED:

1. That the Cheshire and Wirral Partnership NHS Foundation Trust Quality Account 2022-23 presentation be received and noted.
2. Maddy Lowry to be invited to a future Committee meeting to present the Autism Strategy.

To receive an update from East Cheshire NHS Trust on the return of intrapartum care to Macclesfield District General Hospital.

Kate Daly-Brown, Director of Nursing and Quality attended Committee to provide an update on plans to safely return full intrapartum care to Macclesfield District General Hospital (DGH).

The Committee was informed that intrapartum services at Macclesfield DGH were suspended in March 2020 in preparation for the surge in critical care linked to the COVID-19 pandemic. The service was suspended initially for a six-month period as a result of limited anaesthetic capacity within the Trust, however this suspension was subsequently extended a further three times following assessments against the approved recovery criteria. It was confirmed that whilst intrapartum services at the hospital had been suspended, the Trust had continued to deliver home births and provided antenatal and postnatal care.

The Committee was pleased to learn that the Trust had achieved its targets to allow the safe reinstatement of intrapartum services to Macclesfield DGH and that services officially returned on Monday 26 June 2023 and eight babies had been successfully delivered at the hospital to date.

The Committee noted that the Trust had committed to completing a post implementation review following a three-month period of service delivery. Committee Members requested that the findings of this review be presented to the Scrutiny Committee at the appropriate time as Members were keen to ensure that services at Macclesfield DGH remained sustainable. 

RESOLVED:

1. That the report on intrapartum services at Macclesfield DGH be received and noted.

To receive and provide feedback on the Safer Cheshire East Partnership Annual Report and Strategic Intelligence Assessment.

Jill Broomhall, Director of Adult Social Care and Chair of the Safer Cheshire East Partnership (SCEP), presented the SCEP Annual Report 2022-23 and Strategic Intelligence Assessment 2022-25 to the Committee.

It was reported that, during 2022-23, a number of sub-groups were established within SCEP to undertake SCEP plans, mitigate risk, provide support, impact on outcomes and increase public confidence and awareness. The Committee queried the ‘Get Safe Online’ group which was established to tackle the challenges that online scams presented and the communication mechanisms in place to share this information with residents. It was noted that an external organisation had been commissioned to manage communications/information sharing and that a number of informative events had been held. It was agreed amongst Committee members that additional communications on social media platforms such as Facebook were needed to promote awareness and improve education on online scams.

It was noted that knife crime had been identified as a priority in the new SCEP Strategic Intelligence Assessment for 2022-25 and that during the period April 2021-March 2022 there were 112 incidents involving weapons recorded. In May 2023, Cheshire East (Crewe) hosted, in partnership with Crewe Town Council, the Knife Angel, an emotive sculpture formed of 100,000 knives collected via a national knife amnesty. Committee Members queried how domestic knives should be appropriately disposed of and the statistics associated with knife crime in both adults and young people. Jill Broomhall committed to providing a written response.

The Committee queried the membership of the SCEP and it was reported that, historically, the Portfolio Holder for Communities had been a member of the Partnership. Jill Broomhall welcomed the opportunity for a member of the Scrutiny Committee to be represented on SCEP going forward as Cheshire East Council no longer had Portfolio Holders under the Committee System. It was agreed that this would be referred to the Head of Governance and Democratic Services to investigate how this position could be appointed to in consultation with Group Administrators.

RESOLVED:

1. That the Safer Cheshire East Partnership Annual Report 2022-23 and Strategic Intelligence Assessment be received and noted.

To appoint Members to the Cheshire and Merseyside Integrated Care System Joint Health Scrutiny Committee.

Consideration was given to the report which sought approval from the Scrutiny Committee to appoint members to the Cheshire and Merseyside Integrated Care System Joint Health Scrutiny Committee.

It was proposed and seconded and subsequently carried that Cllr Wardlaw be confirmed as the Conservative representative for Cheshire East.

It was proposed and seconded and subsequently carried that Cllr Vernon be confirmed as the Labour representative for Cheshire East. 

RESOLVED:

That the Scrutiny Committee:

1. Appoints the membership of the Cheshire and Merseyside Integrated Care System Joint Health Scrutiny as follows: Conservative 1. Labour 1.

2. Notes the ‘Protocol for the Joint Health Scrutiny Arrangements’ attached as appendix 1 to the report.

To consider the Work Programme and determine any required amendments.

Consideration was given to the Committee Work Programme. It was confirmed that an update from the North West Ambulance Service had been added to the Committee Work Programme for its meeting in December 2023.

Committee Members put forward the following potential items for the Work Programme:

-       Dentistry capacity to accept new patients, particularly young children.

-       Pharmacracy provision across the Borough following the update provided to Committee in March around Lloyds Pharmacy closures and the recent announcement that Boots would be closing 300 stores across the UK over the next 12 months.

-       Health and inequalities across the borough.

Officers committed to review the proposed Work Programmes items with the Chair and Vice Chair.

RESOLVED:

1. That the Committee Work Programme be noted.

2. Microsoft Teams session to be arranged for Committee to discuss potential Work Programme items for the new municipal year.