Agenda item

(1)       The Committee concluded as follows from the meetings held on 9 and 27 November:-

a)             To note that part of the Director of Public Health’s role is to proactively monitor infection prevention and control across the Kent and Medway Health economy;

b)             To ensure that the Strategic Health Authority and Primary Care Trusts share best practice by individual Trusts, so that there is a consistent approach across the Kent and Medway health economy;

c)             To seek clarity on the respective roles of Primary Care Trusts, the acute hospital Trusts and the Strategic Health Authority;

d)             To seek clarity about how the Primary Care Trusts are dealing with the issue of antibiotic prescribing;

e)             To consider what methods are being used by health organisations to inform patients and the public about how they can help avoid infection risks;

f)               To welcome the opportunity to receive an action plan from the Maidstone and Tunbridge Wells NHS Trust on how they are responding to the Healthcare Commission report, having heard that bed occupancy within the Maidstone and Tunbridge Wells NHS Trust was currently at 95% instead of the recommended level of 85%;

g)             At a future meeting, to understand how adult social care, health and other stakeholders are responding to the issue of step-down facilities and delayed discharge;

h)             To understand from the Strategic Health Authority how the money recently allocated by the Government for deep cleaning is to be allocated to Trusts across the Kent and Medway Health Economy;

i)               To welcome the offer of the Healthcare Commission to provide some training for Members of the Committee on what makes a good third-party dialogue contribution to the Annual Health Check;

j)                To welcome the Healthcare Commission’s offer for Members to accompany them on some visits to health organisations, so that Members may see at first hand how the Committee can contribute to the Healthcare Commission’s Annual Health Check;

k)             To state that the cleaning of health establishments should include the non-clinical areas, especially above head height;

l)                To state that deaths that might be related to adverse effects of medical treatment or to poor standards of care, or where there has been any complaint about healthcare services, should be referred to the relevant Coroner as a matter of routine;

m)           To write to the Government responding to the draft regulations for Local Involvement Networks;

n)             To ensure that relevant information is sent to the Healthcare Commission and, if appropriate, the minutes of each Health Overview and Scrutiny Committee meeting;

o)             To encourage Members of the Health Overview and Scrutiny Committee to attend meeting of local health organisations’ Boards;

p)             To build into the Committee’s work programme as core business the matter of compliance with the Healthcare Commission’s Core Standards;

q)             To have a dialogue with the existing Patient and Public Involvement Fora, the Local Involvement Network (when established), Patient Advice and Liaison Services, Independent Complaints Advocacy Services, local Members of Parliament and local councillors; to listen to patients’ concerns; and to utilise more effectively information that is provided and act on concerns that are expressed;

r)               To ensure that the good work going on in various local level Patient and Public Involvement Fora feeds into the Health Overview and Scrutiny Committee to enable it to provide an evidence-based strategic view across the county;

s)             To analyse whether, if the Committee had operated in the style that it does now when it asked colleagues from Kent and Medway health economy to address the Committee on infection control in October 2004, July 2006 and June 2007, the public would have been better served;

t)               To consider whether it has helped for the Committee to seek written evidence in advance of each meeting, agree a work programme (up to two years ahead) and link this to the training of Members for service on the Committee;

u)             To consider the role of senior clinicians in changing the leadership and culture of NHS organisations;

v)              To support measures to ensure that a correct balance of food is eaten by patients in hospitals, having due regard to the patients’ clinical needs;

w)            To consider whether spot checks of hospital food suppliers should be undertaken by Environmental Health and Trading Standards;

x)              To investigate what training adult social care and health providers undertake to ensure that infections in the community are not brought into hospitals;

y)              To consider how the County Council can help with a campaign to advise the public on taking steps to help avoid infection in hospitals and elsewhere.

z)              To seek the views of microbiologists on the effectiveness of different cleaning products against Clostridium difficile;

aa)        To examine the role of non-executive directors on the Boards of NHS bodies;

bb)        To look at possible inequalities in the funding of health services and the impact of this on ratios of nurses and healthcare assistants;

cc)         To understand how Trusts spend their budgets;

dd)        To undertake a review of arrangements regarding hospital visitors.

Recommendations

The Vice Chairman, and the Conservative and Liberal Democrat spokesmen would like to suggest the following recommendations to the Committee, having heard and considered the conclusions of the evidence taken by the Committee at its meetings on 9 and 27 November:

a)             At the heart of the Health Overview and Scrutiny Committee’s work programme should be the Healthcare Commission Core Standards.

b)             Evidence should be recorded from the Health Overview and Scrutiny Committee’s work programme electronically, so that when the Health Overview and Scrutiny Committee is asked to make third-party submissions for the Annual Health Check the evidence for this is already available.

c)             There should be greater collaboration between the Patient Advice and Liaison Services, the Independent Complaints Advocacy Services, the Patient and Public Involvement Fora / the Local Involvement Network, Members of Parliament and local authority councillors, in order to listen to patient concerns and utilise more effectively the information they provide to assist in formulating the Health Overview and Scrutiny Committee’s work programme.

d)             The Overview and Scrutiny Manager should, together with colleagues from health organisations, explore and arrange an ongoing programme of training and activities to address the knowledge deficit for all stakeholders involved in scrutinising the health economy.

e)             Recognising that the patient and public view is paramount, the Health Overview and Scrutiny Committee and the County Council should respond to the draft regulations for Local Involvement Networks to ensure that there is an adequate right to inspect premises where healthcare is provided.  This will make for robust scrutiny, helping to bring about health improvements and reduce health inequalities – which are the fundamental principles of Health Overview and Scrutiny.