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  • Agenda and minutes
  • Agenda and minutes

    Venue: Council Chamber, Sessions House, County Hall, Maidstone. View directions

    Contact: Lizzy Adam  03000 412775

    Media

    Items
    Note No. Item

    54.

    Declarations of Interests by Members in items on the Agenda for this meeting.

    Additional documents:

    Minutes:

    (1)       Mr Chard declared a Disclosable Pecuniary Interest as a Director of Engaging Kent. Mr Chard apologised to the Committee for not withdrawing from the meeting on 2 September during the Healthwatch Kent item, after having declared an interest at the beginning of the meeting.

    55.

    Minutes pdf icon PDF 150 KB

    Additional documents:

    Minutes:

    (1)       The Scrutiny Research Officer updated the Committee on the following actions that had been taken since 2 September:

    (a)       Minute Number 19 - Emotional Wellbeing Strategy for Children, Young People and Young Adults. At HOSC on 4 March the Committee requested that NHS West Kent CCG be invited to attend a meeting of the Committee in six months to provide an update. In September NHS West Kent CCG requested that an update be provided once the contract had been awarded which the Chairman agreed to. An update paper was circulated to Members on 5 September.

     

    (b)       Minute Number 25 - Kent and Medway NHS and Social Care Partnership Trust. At HOSC on 8 April during the Kent and Medway NHS and Social Care Partnership Trust (KMPT) item, a Member requested information about the Trust’s work with the community and voluntary sector as part of their next update to the Committee. Upon clarification, the Member confirmed that information related to the new Live Well Kent contract being delivered by the Shaw Trust and Porchlight.

     

    A written briefing regarding the Live Well Kent contract - a new community mental health and wellbeing service commissioned jointly by Kent County Council (KCC) and the seven CCGs in for Kent was circulated to Members on 26 September. A Member requested that the written briefing was resent to Members and the Scrutiny Research Officer undertook to do this.

     

    (c)        Minute Number 51 - SECAmb: Update.  Mr Angell reminded the Committee that at HOSC on 2 September, the Committee requested that South East Coast Ambulance NHS Foundation Trust (SECAmb) share the findings of the Patient Impact Review and CQC Inspection Report upon publication.

     

    Mr Angell noted that the CQC Inspection Report for SECAmb was published on 29 September (on the same day as Agenda publication); the Trust received an overall rating of Inadequate by the CQC and NHS Improvement subsequently placed the Trust into Quality Special Measures.

    Mr Angell stated that he had attended the Quality Summit with the Chairmen of the six HOSCs in the South East. He reported that concerns were raised about the number of formal committees the Trust may need to attend following the publication of the CQC report which could impact on the delivery of improvements by the Trust.

     

    Mr Angell explained that, in order to minimise this, there was a proposal for the Chairs of the six HOSC to form a working group to monitor the Trust's improvement plan and to report back to their individual committees. A Member enquired if Members would have access to minutes and papers of the working group, the Scrutiny Research Officer explained that the Terms of Reference were being drafted and it was her understanding that Members would have access to those. Mr Inett asked if Healthwatch could be involved in the working group, the Scrutiny Research Officer undertook to raise this with the South East Health Scrutiny Network.

     

    (d)       Minute Number 49 – All Age Eating Disorder Service in Kent and Medway.  ...  view the full minutes text for item 55.

    10:05

    56.

    Kent and Medway NHS and Social Care Partnership Trust: Update pdf icon PDF 67 KB

    Additional documents:

    Minutes:

    Helen Greatorex (Chief Executive, Kent and Medway NHS and Social Care Partnership) and Vincent Badu (Director of Transformation (Integrated Older People’s Services), Kent and Medway NHS and Social Care Partnership) were in attendance for this item.

    (1)       The Chairman welcomed the guests to the Committee. Ms Greatorex began by explaining that she and Mr Badu were in new post; Ms Greatorex had been working for the Trust for four months and Mr Badu had joined the Trust two weeks ago. She stated that she had been really impressed with the Trust and the opportunities for improvements.

    (2)       Ms Greatorex reported that she had three immediate priorities. The first was the reduction in private bed use. She explained that on her first day at the Trust there were 76 patients in private beds, in locations as far away as Manchester and Hull, which was costing the Trust over £1 million a month. She stated that she had set a target of no more of 15 private beds being used by 1 November and the Trust was currently using 21 private beds. She noted that there had been positive feedback from families of patients who had been repatriated.

    (3)       Ms Greatorex stated her second priority was to improve Section 136 detention and roll out Street Triage across Kent and Medway, a programme where mental health professionals worked with police officers to divert and support people at risk of Section 136 detention. She noted that she had already had constructive dialogue with the Police & Crime Commissioner and the Assistant Chief Constable. She noted that her third priority was to carry out a thorough review of Older People’s Services to ensure high quality, evidence based, person centre care was being provided.

    (4)       Mr Badu stated that he had been appointed the Director of Transformation at the Trust and had previously been a Director at the Sussex Partnership NHS Foundation Trust focusing on Section 136 detention and Older People’s Services.  He noted the importance of good quality care being provided to older people whilst in a crisis and supporting those who can be treated at home. He reported that he had spent the last two weeks travelling across Kent and Medway to see the delivery of services and engaging with partners and stakeholders.

    (5)       Members of the Committee then proceeded to ask a series of questions and make a number of comments. A Member enquired about the Trust’s collaboration with other organisations in relation to Section 136 detentions. Ms Greatorex explained that only 20% of people who were detained, under Section 136, required inpatient admission; 80% of people had another issue such as alcohol or drug use. She stated that the Trust had a strong partnership with the Police; she highlighted that from April 2017 people detained under Section 136 could no longer be taken into Police Custody.   She noted that the Trust needed to work more closely with local authorities to offer support to people who were intoxicated. Mr Badu added that mental health  ...  view the full minutes text for item 56.

    10:45

    57.

    Medway NHS Foundation Trust: Update pdf icon PDF 96 KB

    Additional documents:

    Minutes:

    Diana Hamilton-Fairley (Medical Director, Medway NHS Foundation Trust) and Shena Winning (Chairman, Medway NHS Foundation Trust) were in attendance for this item.

    (1)       The Chairman welcomed the guests to the Committee. Ms Winning began by explaining that the Trust last visited the Committee in March 2016 following the CQC inspection in August 2015.  She stated that the Trust was currently preparing for a further inspection taking place in November 2016. She introduced Dr Hamilton-Fairley who was the interim Medical Director, as part of the Trust’s buddying agreement with Guy’s and St Thomas’ NHS Foundation Trust (GSTT).

    (2)       Dr Hamilton-Fairley stated a further CQC inspection would take place on 29 & 30 November 2016. The CQC had undertaken a fieldwork visit in March 2016 and the CQC had reported that the hospital was safer for patients and the leadership & staff engagement at the Trust had improved. She highlighted a number of improvements which had been made in the last six months:

    §  65% of ambulance patients were seen within 15 minutes of arrival; the A&E was now the highest performing Trust in the region;

    §  The refurbishment of the new 24 bed majors unit had begun and was expected to be completed by December 2017;

    §  The Trust was regularly performing above 80% for patient being seen and treated within four hours; the Trust had moved from 127th to 86th in the performance tables;

    §  Patients requiring a KMPT acute inpatient bed were being admitted within 24 hours.

    (3)       Dr Hamilton-Fairley noted that the Trust had introduced a new Medical Model in March 2016. Following the introduction of the model 60% of patients were now discharged within 48 hours and overall length of stay had reduced. She reported that the Friends and Family test had risen above 80% for the first time in 18 months and the number of consultants seen by the patients was reducing. She stated as part of the new ambulatory care unit, GPs were able to directly refer patients to the unit and bypass the Emergency Department.

    (4)       Dr Hamilton-Fairley noted that staffing and finance were two areas of challenge. The Trust had been unable to recruit English trained staff and 75 Skype interviews had been scheduled with foreign staffing. She stated that nursing vacancies in the Emergency Department had reduced from 60% to 25%. She reported that the Trust had forecast a deficit of £40 million for 2016/17 and was aiming to make saving of £12.8 million through procurement and estate efficiencies.

    (5)       Dr Hamilton-Fairley highlighted that two CT scanners and a MRI scanner located in the car park would be installed by the end of the year to reduce waiting times. She noted that the hospital would become smoke free from 17 October with onsite support for staff and patients by Medway Council’s Stop Smoking Service. She reported that the Trust was working closely with partners, including KMPT and Maidstone & Tunbridge Wells NHS Trust, as part of the Sustainability and Transformation Plan for Kent and  ...  view the full minutes text for item 57.

    11:30

    58.

    Kent Health & Wellbeing Board Annual Report pdf icon PDF 268 KB

    Additional documents:

    Minutes:

    Roger Gough (Cabinet Member for Education and Health Reform, Kent County Council) and Karen Cook (Policy and Relationships Adviser (Health), Kent County Council) were in attendance for this item.

     

    (1)       The Chairman welcomed the guests to the Committee. Mr Gough began by highlighting the three strands of 2015/16 Annual Report. The first was the statutory responsibilities of the board including the production of the Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategy (JHWS). In 2015/16 both core documents were reviewed. An event was held in September 2015 to revise the JSNA to enable it to provide better support to Commissioners when making commissioning decisions; a more forward looking JSNA Plus was being developed. A mid-term review of the current JWHS was also held; work was underway to see how the new strategy could align with the Sustainability and Transformation Plan.

     

    (2)       Mr Gough stated that the second strand of the Annual Report was the major topics considered by the Board including the Kent & Medway Mental Health Crisis Care Concordat to reduce number of detentions under Section 136 of the Mental Health Act 1983;  Learning Disability – Joint Health and Social Care Self-Assessment Framework and update on Transforming Care (Winterbourne);  Emotional Wellbeing Strategy for Children, Young People and Adults which had articulated a new family focused model of care. The Board also reviewed the five outcomes set out in the Joint Health and Wellbeing Strategy: best start in life; prevention; people with long term conditions; people with mental health issues and people with dementia.

     

    (3)       Mr Gough noted that the third strand of the Annual Report was the development of the Kent and Medway STP. The Board had been involved early on in the process and had had discussions in open and closed session. He reported that one of the strengths of the Kent and Medway STP was strong clinical engagement. There were a number of areas which fed into the Board through the STP such as workforce and estates. He explained that the STP also raised questions regarding the role of the Board going forward particularly how the Board fits into the governance process and the purpose of the Joint Health and Wellbeing Strategy if the Kent & Medway STP was strong.

     

    (4)       Members enquired about HOSC’s role with the STP and the impact of the STP on surrounding areas. Mr Gough explained that a further submission by the Kent & Medway STP was due on 21 October. He noted that an earlier version of the STP was submitted in the summer and reviewed by Simon Stevens (Chief Executive, NHS England) and Jim Mackey (Chief Executive, NHS Improvement) and there had been a positive discussion. He stated that there was a considerable amount of work to do in Kent and Medway particularly in creating a financially sustainable system to reflect the Five Year Forward View without new legislation and within a short time frame. He expected the CCGs to take further information about the STP to their Governing Bodies  ...  view the full minutes text for item 58.