Agenda and minutes

Councillor Michael Lyons declared a personal interest in the Agenda as a Governor of East Kent Hospitals University NHS Foundation Trust.

(a)       The Vice-Chairman reported to the Committee that following a meeting with the relevant Cabinet Member, January was proposed as the date for the Committee to consider Child and Adolescent Mental Health Services (CAMHS).

(b)       RESOLVED that the Minutes of the meeting of 6 September 2013 are correctly recorded and that they be signed by the Chairman.

The Committee is asked to Note the following dates for meetings in 2014:

Fri, 31 January

Fri, 7 March

Fri, 11 April

Fri, 6 June          

Fri, 18 July

Fri, 5 September

Fri, 10 October

Fri, 28 November

AGREED that the meeting dates for 2014 be noted.

(a)       The Chairman introduced the item and explained that it was a written follow-up to the discussion the Committee had on the East Kent Hospitals University NHS Foundation Trust’s clinical strategy in June and that the intention was for the issue to return to HOSC following the public consultation.

(b)       Comments were invited from Members. Several comments were made as to the importance of including information about travel to the 6 sites where services would be provided. One Member used the analogy of supermarkets, with the need for services to be where the demand was. On the topic of the number of sites, one Member referred to the discussion in June when NHS representatives mooted the possibility of a 7^th site on Sheppey and hoped there would be clarification as to whether this was still the case.

(c)        On the plans for public meetings, the report in front of Members stated that there were plans to hold one in either Hythe or Dymchurch. One Member requested a meeting be held in both towns.

(d)       The Chairman drew attention to the part of the NHS report where a request was made for volunteers from HOSC to read and comment on the draft consultation document. The following Members of the Committee volunteered:

§         Dr M Eddy

§         Mr R Latchford, OBE

§         Councillor Michael Lyons

(e)       The Chairman proposed the following recommendation:

§         That the Committee note the report, ask the NHS to take on board the comments and questions raised by the Committee and that a small group be formed to liaise with the NHS on the draft consultation document.

(f)         AGREED that the Committee note the report, ask the NHS to take on board the comments and questions raised by the Committee and that a small group be formed to liaise with the NHS on the draft consultation document.

Ian Ayres (Chief Officer, NHS West Kent CCG), Helen Medlock (Associate Partner, KMCS), Deborah Tobin (Senior Associate, KMCS), Alastair Cooper (Managing Director, NSL Care Services), Paul Costello (Client Account Manager, NSL Care Services), Felicity Cox (Kent and Medway Area Director, NHS England), and Dr John Allingham (Medical Secretary, Kent LMC) were in attendance for this item.

(a)       The Chairman introduced the item and asked the Committee’s guest to explain the background and the current situation.

(b)       It was explained that NSL Care Services took over the provision of Patient Transport Services (PTS) on 1 July 2013. This came at the end of a two year process. Previously there had been a patchwork of five providers, of which four were major providers. A decision had been reached by the old Primary Care Trust Board that a single provider was preferable. It was still the consensus now that one provider was preferable. The bid from NSL scored the best on value for money and quality.

(c)        The transfer to the new provider was very complex given the number of different providers previously with different shift patterns, fleets, operating procedures, organisational cultures and so on. 100 staff needed to be transferred under TUPE to the new provider. It was openly admitted that the transfer had not gone to plan. It was explained that there were two parts to the service. The first part, that of whether appointments were able to be booked, was going to plan. However, the second part, that of whether patients were being picked up and taken to their appointments at the appropriate time, was not. NSL were currently achieving 60-65% regarding timeliness.

(d)       Both the commissioner and provider apologised for this. It was explained that there was a recovery plan in place and things were improving. There were a number of performance indicators in the contract and Mr Ayres stated that he received updates on the 5-6 key ones daily, the top 8-9 ones weekly and the rest monthly. Performance data was being shared with the Acute Trusts and an independent expert was being brought in to review the measures being taken to improve the situation and this would report before the winter. NHS England was supportive of this approach.

(e)       It was further explained that the PTS eligibility criteria had not changed from the previous arrangement and that the criteria in Kent and Medway was more generous than elsewhere. They had been applied inconsistently in the past. It was reported that press stories about people being refused transport were cases where someone was not eligible for PTS or had not requested the service. A request was made for the eligibility criteria to be made available to the Committee.

(f)         One Member commented that subsequent to a recent news story, he had been contacted with a number of further examples. It was accepted that there was a problem around public confidence with the service.

(g)       Representatives from NSL explained that they had underestimated the challenge of setting up  ...  view the full minutes text for item 6.

Roger Gough (Cabinet Member for Education and Health Reform), Felicity Cox (Kent and Medway Area Director, NHS England), and Dr John Allingham (Medical Secretary, Kent LMC) were in attendance for this item.

(a)       The Chairman welcomed the Cabinet Member for Education and Health Reform and invited him to present an overview to the Committee. A copy of the PowerPoint is appended to these Minutes.

(b)       It was explained that the creation of Health and Wellbeing Boards (HWBs) formed part of the Health and Social Care Act 2012. They have become one of the most accepted parts of what was, in other aspects, a strongly contested piece of legislation. They are viewed as part of the architecture that works. The Health Select Committee at the House of Commons was originally sceptical of HWBs but is now a strong supporter of them.

(c)        Much of the membership of the Kent HWB follows the statutory requirement, but there are additions. There is more than one KCC Member on the Board and there are three representatives from the Borough/City/District Councils across Kent. It follows the principle that no group should have a majority and has a strong emphasis on consensus. There has not been a vote required thus far and it would in a sense be a failure if one was required.

(d)       In terms of its role, it took over responsibility for the Joint Strategic Needs Assessment (JSNA). It is responsible for the production of the Pharmaceutical Needs Assessment. This is a technical document and work on it is due to begin at the next HWB meeting. The third document, the Joint Health and Wellbeing Strategy (JHWS) takes centre stage as it sets out the vision for health and social care across the county. Health and social care commissioning plans need to be aligned to it. During the passage of the Health and Social Care Act, the role of the HWB in promoting integration was strengthened and this is now a key part of its role.

(e)       The Health and Wellbeing Board took on its statutory role on 1 April 2013 and its meetings have been webcast since this time. Before this, a shadow board was in existence from September 2011. During this time, GPs and local authorities have become increasingly used to working together.

(f)         Five priorities were set out in the first iteration of the JHWS earlier this year. These are: young people, prevention of ill health, long term conditions, mental health, and dementia. Thus far, each meeting of the HWB has concentrated on one of these priorities. At the next meeting, the focus will be on mental health.

(g)       In the days before the HWB took on its statutory role, the operating plans of all seven Clinical Commissioning Groups (CCGs) across Kent were considered in terms of how far they shared a common view. The additional point was made that more needed to be done on bringing the plans of social care, NHS England’s direct commissioning  ...  view the full minutes text for item 7.