Agenda and minutes

Councillor R Domleo, Portfolio Holder for Adult Services;

Councillor A Knowles, Portfolio Holder for Health and Well Being;

Councillor A Thwaite, Chairman of Corporate Scrutiny Committee

To provide an opportunity for Members and Officers to declare any personal and/or prejudicial interests in any item on the agenda

There were no declarations of interest made.

To approve the minutes of the meeting held on 16 September 2009.

RESOLVED:  That the minutes of the meeting of the Committee held on 16 September be approved 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 the minutes of the meeting of the Cheshire and Wirral Council’s Joint Scrutiny Committee held on 8 October 2009.

The Committee considered the minutes of the meeting of the Cheshire and Wirral Councils’ Joint Scrutiny Committee held on 8 October.

RESOLVED:  That the minutes be received.

Fiona Field, Director of Governance and Strategic Planning, Central and Eastern Cheshire Primary Care Trust will update the Committee on the current position with the Strategic Plan – presentation attached.

Fiona Field Director of Governance and Strategic Planning, Central and Eastern Cheshire Primary Care Trust (PCT), presented the Commissioning Strategy 2009 – 16, Refresh of Terminology Document.  The document was a draft but was submitted for Members’ comments.

The PCT’s ambition as described in the document was “To work with others to achieve sustainable improvements in health and wellbeing of the population and to reduce inequalities in health”.  There were 4 Visions:

• Healthy Communities;
• Accessible Healthcare;
• Better Healthcare;
• High Performing Trust.

For each Vision, a number of Success Outcomes were listed together with Accountable Measures.  This was expanded upon in sections headed “A step change to…” whereby the Trust outlined “What We Did” (actions undertaken), “What you think” (stakeholder feedback and images of performance activity) and “How we performed” (accountable measures of performance).

During discussion of the Document the following issues were raised:

      That the PCT target for ensuring the numbers of stroke patients who received physiotherapy assessment within 72 hours was to ensure that the national target was consistently met;  there were enough trained physiotherapists to deliver the service following a national drive a few years ago;

      Current issues for the PCT included Chlamydia screening rates, Teenage Pregnancy rates and the 4 hour waiting time for Accident and Emergency, there were also continuing issues around the 18 week target for hospital treatment and the impact of the new proposals announced in the Queen’s Speech. 

      Members noted new proposals in relation to Sex and Relationship Education in schools. 

RESOLVED:  That the report be noted.

The Committee has previously been advised of the current financial situation at the Primary Care Trust and has received the Sustainability Plan devised to address the financial challenges facing the PCT.  Fiona Field, Director of Governance and Strategic Planning, will verbally update the Committee on the current financial position.

Fiona Field, updated the Committee on the current position regarding the Financial Sustainability Plan on which Members had been previously briefed.  She explained that the PCT was still working to the Sustainability Plan and had engaged PriceWaterhouseCoopers who had validated the plan to the PCT Board as deliverable over an 18 month period.

All 53 GP Practices had had a visit from the Chief Executive and Chairman of the Trust to discuss getting the healthcare economy back into balance.  The levels of referrals from primary care had now flattened out and were beginning to slightly reduce.  The £30m deficit predicted previously had now reduced to a £12m deficit. 

During discussion of the item the following issues/questions were raised:

      The reduction in referrals from primary care should continue with the continuing increase in use and provision of new healthcare centres;

      Dementia – this was an increasing issue due to the ageing population and was included in the PCT Strategic Plan to improve dementia services, integrate care provision and ensure dignity and respect for all.  Work was underway with the 2 Hospital Trusts to look at lengths of stay in hospital for dementia patients.  Intermediate care services were useful and helped to address delayed discharge from hospital;

      Pharmacies were able to offer services such as flu jabs and minor ailments; if pharmacies were interested in offering any additional services this could be discussed with the PCT;

      Whether people who were not registered with a GP would use the Accident and Emergency (A and E) unit at the hospital instead - treatment received at A and E was more expensive than treatment in primary care.  The new Urgent Care Centre had recently opened at the Leighton Hospital site and to date approximately 40% of people seen there would previously have gone straight to A and E;

      The implications of the Sustainability Plan meant that Substantial Developments or Variations in Service may not be able to be raised with the Overview and Scrutiny Committee very far in advance;

      Whether the £1m cut in funding to the Cheshire and Wirral Partnership NHS Foundation Trust would be a one off or would the reduction in funding be maintained?  Members were advised that the PCT had had to find savings across the whole of its service areas.

RESOLVED:  That the update be noted and the impact on any future Substantial Developments or Variations in Service be discussed at the mid point meeting.

Fiona Field, Director of Governance and Strategic Planning, Central and Eastern Cheshire Primary Care Trust, will verbally update the Committee on the current situation with Pandemic Flu.  

She will also update the Committee on the uptake of the HPV vaccination programme against cervical cancer – report attached.

The Committee was updated on the current position with Pandemic Flu.  At 17 November 2009, 11,508 people had been prescribed anti viral medicine in the Primary Care Trust (PCT) patch.  The Vaccination campaign was now underway with GPs contacting high risk groups to be vaccinated first; these included pregnant women, people with chronic illnesses and health and social care workers.  Each GP practice had received 500 doses of vaccine and the PCT had received 500.  From week commencing 23 November many more doses of vaccine would be received and a mass vaccination was still planned with children and young people to be the next in line.  Those who had been treated for Pandemic Flu would still be vaccinated because it was not possible to confirm the numbers of Pandemic Flu cases as people were no longer swabbed to test for the virus.  People who received the seasonal flu vaccine could have the Pandemic Flu vaccine too.

The Committee was also updated on the HPV vaccination programme which was part of the Cervical Screening programme.  There was a good uptake in the PCT patch but there had been a significant reduction after a death that had occurred following vaccination which had subsequently been found not to have been connected to the vaccination.  The Committee noted a publicity leaflet from the PCT outlining the reasons for girls to be vaccinated.

RESOLVED:  That the update on Pandemic Flu and the HPV vaccination programme be noted.

To consider a report from Central and Eastern Cheshire Primary Care Trust on the development of the strategy for integrated care.

The Committee considered a draft Vision and Strategy Document for Integrated Care in East and Mid Cheshire.  The Strategy’s aim was to provide better, more personalised services for people and services that were efficient and effective, through integration, where possible. 

Work on the Strategy had been started by officers, lead by a Programme Director, and a Think Tank was to be established which would include the Local Authority Chief Executive and key Members.  A briefing was to be made to Cheshire East Cabinet Members.

A number of existing work streams would be brought together and Heather Grimbaldeston, Director of Public Health at the PCT, was to also be designated Director of Public Health for the Local Authority.

RESOLVED:  That the report be noted and a more detailed report submitted to the next meeting.

Fiona Field, Director of Governance and Strategic Planning, Central and Eastern Cheshire Primary Care Trust, will verbally update the Committee on the consultation process relating to the PCT proposals for future healthcare in Knutsford.

Fiona Field advised the Committee that the formal 12 week consultation period into the future healthcare proposals for Knutsford, had been suspended pending further consideration of site issues.

This Committee had set up a Task/Finish Panel which had held a first meeting with a second meeting planned for the following month.

RESOLVED:  That the current position be noted.

To consider a report of the Borough Solicitor.

The Committee considered the current position with the Work Programme.  

The North West Ambulance Service was scheduled to attend the next meeting on 13 January 2010.

It was suggested that a presentation or training session on the Telecare service would be beneficial to Members of the Committee.

RESOLVED:  That the Work Programme be noted and the proposed presentation on Telecare be discussed at the mid point meeting.