Agenda item

Ailsa Ogilvie (Director of Partnerships & Membership Engagement, NHS Thanet CCG), Caroline Selkirk (Managing Director, NHS East Kent CCGs), Maria Reynolds (Head of Nursing, Quality and Safeguarding, NHS Thanet CCG), Cathy Finnis (Governing Body Member, NHS Thanet CCG) and Matthew Inder (Business Process and Continuous Improvement Manager, Millbrook Healthcare) were in attendance for this item.

(1)  The Chair welcomed the guests to the Committee and asked them to provide a brief overview of their update paper.

(2)  Ms Ogilvie provided the following highlights:

a)    Latest data evidenced continued overarching improvement with reductions in the waiting lists for both equipment and repairs.

b)    Open episodes of care at the end of May 2019 were ahead of the planned trajectory.

c)    The number of children on incomplete episodes of care at the end of May 2019 were slightly behind the planned trajectory.

(3)  Nationally set standards highlighted that all children who required a wheelchair would receive one within 18 weeks. There was no such standard for adults, but G4S had set a target of 23 weeks. Ultimately, Millbrook’s ambition was for both adults and children to receive a wheelchair within 18 weeks of being referred.

(4)  A Member questioned the difference between standard and emergency repairs. Mr Inder explained it was down to the severity of the case and the level of risk presented to the user. Emergency repairs would be dealt with on the same day, whereas standard repairs would be completed within three days. Loan wheelchairs were available where required.

(5)  In relation to the service user experience, the CCG acknowledged that the service still needed to improve, and those service users experiencing long waits would not be happy. Ms Finnis explained that increased engagement with users was underway, including (but not limited to):

a)    Three service user open meetings which had highlighted areas of concern from over 60 users;

b)    The establishment of a Service User Improvement Board, which would meet bi-monthly from 13 August 2019;

c)    Workstream meetings in focused areas would involve service users;

d)    Recruitment to a full-time post within Millbrook was underway.

(6)  The report (page 29 in the agenda) mentioned the upcoming function on the website for service users to upload photos to support their request for repairs. Members were concerned that not all service users would want / be able to use this function. Mr Inder explained that the provider was trialling a number of methods, of which this was just one and did not have to be used by all.

(7)  Mr Inett explained that Healthwatch had been liaising with user forums and advocacy groups of wheelchair services. He welcomed the good progress in relation to reduced waiting times but expressed concern that users continued to receive very different experiences. Some of those waiting experienced mental health issues because of their inability to go about their daily lives.

(8)  Healthwatch and the CCG also liaised, and Healthwatch had requested a presence on the Service User Improvement Board. Mr Inett expressed that Healthwatch would like to carry out an in-depth piece of work once the changes had bedded in.

(9)  A Member questioned the categorisation of formal and informal complaints. Ms Reynolds explained that there had been a historic tendency for “soft concerns” to be classified as formal complaints. These were then unnecessarily processed through the formal complaints process, which delayed a response to what could have been a simple question.

(10)               A Member expressed disappointment at the lack of information in the report about staff satisfaction and training. Mr Inder explained that staff surveys were carried out with the results reported to the CCG. Members requested additional information around this area in 12 months time.

(11)               Referring to page 35 of the agenda pack, Members asked about the difficultly in recruiting to the post of Rehabilitation Engineer. Mr Inder explained that this was a specialist role, of which there was a national shortage. Technicians, locums and in-house expertise tried to fill the gap in the meantime.

(12)               In relation to the phased additional funding from CCGs (page 28 of the report pack), Ms Ogilvie confirmed that this money was to help Millbrook clear the large inherited caseload. The final phase of that funding was under consideration by the CCGs.

(13)               Looking at the graphs in appendix 1 to the report, a Member questioned why the planned and actual lines fluctuated each month. Mr Inder explained that the targets had been revised as a result of the additional funding received as part of the demand and capacity modelling.

(14)               The Chair informed the Committee that she was aware of a change in ownership for Millbrook Healthcare, and that staff had been notified the day prior to the HOSC’s meeting. She did not propose that HOSC discussed the associated detail at that time but requested additional written information for the Committee as soon as practically possible.

(15)               Mr Inder confirmed that the company had been acquired by Cairngorms Investment Company after the decision by its Chairman to step away from the business. Members on the Board of Executives at Cairngorms had a healthcare background and were keen to drive their investment through focussing on clinical and service users’ needs.

(16)               A Member voiced concern that the Committee had not been told the information until the end of the item and requested that in future such information was disclosed earlier. The Chair noted the request.

(17)               Another Member requested that the item be referred to the Care Quality Commission (CQC). It was explained that this was not possible because the company was not registered with the CQC.

(18)               A Member requested that the item return to the next HOSC meeting for thorough overview and scrutiny. The Chair noted the request and committed to explore outside of the meeting how the item could be considered by HOSC going forward. However, she proposed waiting until the additional written information had been received.

(19)               RESOLVED that:

a)    the report be noted;

b)    Thanet CCG provide a written update as soon as practically possible. The update should include:

                                            i.    Assurances that the contractual obligations would remain with the organisation under its new ownership;

                                           ii.    Details of the new company;

                                          iii.    Arrangements for existing staff;

                                         iv.    Any information relating to significant changes in the delivery of services.

c)    Thanet CCG return to the Committee at the appropriate time.