Agenda and minutes

Apologies for absence were received from Cheshire East Councillors C Andrew and C Beard (substitute - Councillor B Silvester) and Cheshire West and Chester Councillors A Dawson, J Grimshaw and G Smith.

Sheena Cumiskey, Chief Executive, Cheshire and Wirral Partnership NHS Foundation Trust;

Ursula Martin, Associate Director, Cheshire and Wirral Partnership NHS Foundation Trust;

Natalie Park, Associate Director, Cheshire and Wirral Partnership NHS Foundation Trust;

Mike Flynn, Legal and Democratic Services, Cheshire East Council

Denise French, Legal and Democratic Services, Cheshire East Council

To appoint a Chairman of the Joint Committee.

RESOLVED:  That Cheshire East Councillor D Flude be appointed Chairman of the Joint Scrutiny Committee.

To appoint a Vice Chairman of the Joint Committee.

RESOLVED:  That Cheshire West and Chester Councillor P Lott be appointed Vice Chairman of the Joint Scrutiny Committee.

RESOLVED:  That the name of the Spokesperson from Wirral Borough Council be notified to the Secretary.

To appoint a Secretary to the Joint Committee.

RESOLVED:  That Cheshire East Council be appointed Secretary to the Joint Scrutiny Committee for 2010 -11.

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

RESOLVED:  That the following Declarations of Interest be noted:

      Councillor D Flude, Personal Interest on the grounds that she was a Member of the Alzheimers Society and Cheshire Independent Advocacy;

      Councillor P Lott, Personal Interest on the grounds that she was a member of the Local Involvement Network; and

      Councillor D Roberts, Personal Interest on the grounds that her daughter was an employee of the Cheshire and Wirral Partnership NHS Foundation Trust.

To approve the minutes of the meeting of the Committee held on 12 April 2010.

RESOLVED:  That the minutes of the meeting of the Committee held on 12 April be confirmed as a correct record.

A “Jargon Buster” of frequently used acronyms and abbreviations is attached for the Committee’s reference.

The Jargon Buster was noted.

The draft Quality Account of the Cheshire and Wirral Partnership NHS Foundation Trust is attached for the Committee’s consideration and comment.  The draft document is currently undergoing a consultation period prior to the publication of the final document in June.

Sheena Cumisky, Chief Executive of the Cheshire and Wirral Partnership NHS Foundation Trust (CWP) presented the Quality Account for 2009/10.

The Quality Account was in three parts:

·        A strategic overview;

·        A forward look at priorities and statement of assurance against the three priorities identified against the three principal areas of service quality – ie patient safety, clinical effectiveness and patient experience;

·        A backward look and review of quality performance over the past year.

The Quality Account as presented to the Committee was a draft document for the Committee to comment upon and any comments would be considered by CWP’s Board the following day.

The priorities for improvement included:

Patient Safety

-         improve safety by monitoring trends from Serious Untoward Incident investigations and development of systems to monitor reduction of repeatable themes;

-         reduce preventable falls in in-patient areas by at least 10% by end of March 2011 – the Committee was advised that the current level of falls was 180 per quarter although 97% of these caused low to no harm.  The target would be addressed through monitoring every fall and mapping it against the Falls Policy;

Clinical Effectiveness

-         implement the Advancing Quality programme for schizophrenia and dementia (including development of Patient Reported Outcome Measures).  This was a new regional priority for mental health services and measured clinical and patient reported outcomes to determine the level of care that patients had received benchmarked against a set of agreed “best practice” criteria.

-         Develop integrated care pathways in mental health – this had been highlighted as a priority by commissioners, CWP staff and also service users and carers with an aim of seamless care between primary and secondary care;

-         Review physical healthcare for CWP service users – based on research that suggested people with mental health problems had an increased likelihood of physical health problems and premature death.

Patient Experience

-         Collect real time patient experience data – seek the views of patients and carers/relatives during or immediately after treatment to get accurate and timely feedback.

-         Ensure that patient experience of previous Assertive Outreach service users and carers is sought and continuously monitored during the merger of the Assertive Outreach function into Community Mental Health Teams (CMHTs) – this would include regular reporting to the Joint Scrutiny Committee and the Local Involvement Network.

Part 3 of the Quality Account contained a Review of Quality Performance over 2009/10 and specific work to improve the quality of services included:

·        Investment of £2.8 million to co-locate all adult and older people’s services on a single site with improved facilities at Springview Hospital on Wirral;

·        Establishment of three health facilitator posts in mental helath services to support public health and health promotion and work with partners;

·        Opening in September 2009 of the Maple Ward, a new 10 bedded emergency service for young people aged betweek 13 and 18 to enable in-patient mental health care to be available for admissions from across Cheshire and Merseyside for 24 hours a day;  ...  view the full minutes text for item 46.

To consider reports from Cheshire and Wirral Partnership NHS Foundation Trust on the following 2 Substantial Developments or Variations in Service:

      Delivering high quality services through efficient design;

      Redesigning adult and older people’s mental health services in Central and Eastern Cheshire

The Committee considered the reports of the Cheshire and Wirral Partnership NHS Foundation Trust (CWP) on the outcome of the public consultation on the following Substantial Developments or Variations in Service (SDVs):

      Delivering high quality services through efficient design - how CWP proposed to deliver high quality mental health, drug and alcohol and learning disability services.  The consultation exercise had been independently analysed by the Faculty of Health and Social Care at the University of Chester.  They concluded that there were a small number of respondents to the questionnaire contained within the consultation document (32) and a significant majority supported the position of CWP in terms of the necessity to redesign mental health services to deliver greater efficiency.  There was a general view that the main driver for the development of mental health services was underpinned by a reduction in in-patient beds which was itself driven by financial issues.  Some respondents raised concerns regarding access to in-patient services and poor public transport facilities.  There was general support for the development of small specialist units across the Trust’s geographical areas and a request for an improvement in communication of information. 

      Redesigning Adult and Older people’s mental health services in Central and Eastern Cheshire – the proposed provision of all adult and older persons’ acute mental health inpatient services from a single site.  This consultation exercise had also been independently analysed by the Faculty of Health and Social Care at the University of Chester.  They concluded that there were a small number of respondents to the questionnaire contained within the consultation document and many accepted the position of CWP in terms of the need to redesign mental health services and understood the position regarding financial constraints.  Concerns were expressed about the potential location of a single unit and access to it.  No significant issues were raised that would suggest that from a consultation point of view CWP needed to reconsider or revise their intentions.

The Committee was advised that a total of 7 public meetings had been held on the SDVs and 200 people had attended overall.  One consistent theme was around the provision of support to carers.  CWP had also received responses on behalf of organisations as well as individual responses.  The results of the consultation exercise would be considered by the CWP Board the following day.

Members noted the work undertaken to consult on the two sets of proposals and the disappointing number of responses.  It was felt that some wording could have been made more clear and simple and that one concern regularly mentioned was regarding a balance between a need for in-patient beds and community based care and support.  There was also concern regarding the possible location of any new unit in Central and Eastern Cheshire. 

RESOLVED:   That the reports on the outcome of the public consultation be received and further reports be made to the Joint Scrutiny Committee covering the Committee’s response and the proposals for implementing both sets of proposals.