Agenda and minutes

RESOLVED that Councillor Virgo be elected as chairman of the Health Overview and Scrutiny Panel for the municipal year 2014-15.

RESOLVED that Councillor Mrs McCracken was appointed as vice chairman for the municipal year 2014-15.

To approve as a correct record the minutes of the meeting of the Health Overview and Scrutiny Panel held on 13 March 2014.

RESOLVED that the Minutes of the Panel held on 13 March 2014 were approved as a correct record and signed by the Chairman.

Members are requested to declare any Disclosable Pecuniary Interests and/or Affected Interests and the nature of those interests, including the existence and nature of the party whip, in respect of any matter to be considered at this meeting.

Any Member with a Disclosable Pecuniary Interest or an Affected Interest in a matter should withdraw from the meeting when the matter is under consideration and should notify the Democratic Services Officer in attendance that they are withdrawing as they have such an interest. If the Interest is not entered on the register of Members interests the Monitoring Officer must be notified of the interest within 28 days.

There were no declarations of interest.

Any other items which, pursuant to Section 100B(4)(b) of the Local Government Act 1972, the Chairman decides are urgent.

There were no urgent items of business.

To receive submissions from members of the public which have been submitted in advance in accordance with the Council’s Public Participation Scheme for Overview and Scrutiny.

There were no submissions from members of the public.

To meet Mr Andrew Morris, Chief Executive of Frimley Park Hospital NHS Trust, with particular reference to the Trust’s services to residents of Bracknell Forest, and progress on the Trust’s prospective acquisition of Heatherwood and Wexham Park Hospitals NHS Foundation Trust.

The Chairman welcomed Andrew Morris, Chief Executive of Frimley Park Hospital NHS Foundation Trust, to the meeting to speak on the Trust’s services to residents of Bracknell Forest and progress on the Trust’s prospective acquisition of Heatherwood and Wexham Park Hospitals NHS Foundation Trust.  Background information had been circulated to the Panel in advance of the meeting, as follows:

·                     Minute from the Panel’s meeting on 2 February 2012, the last time that representatives of the Trust had attended a Panel meeting;

·                     Relevant summary information from the websites of Frimley Park Hospital and Monitor;

·                     The latest inspection report by the Care Quality Commission;

·                     A briefing paper from Frimley Park Hospital on the proposed acquisition.

Andrew Morris spoke to the Panel, and the points made included in the following:

·                     The Trust wished to provide consultant-led services and specialisation, and it had been recognised that, in order to have a sufficiently large enough patient catchment to do this, the Trust would need to undergo a merger with another Trust.  The proposed acquisition of Heatherwood and Wexham Park Hospitals NHS Foundation Trust would allow enable better, more comprehensive care and local specialist services.

·                     It was envisaged that consultants, rather than patients, would travel between sites.  It was likely that a small percentage of patients would be required to travel to a different site, but this would be to access specialist services.

·                     All hospitals were required to make budgetary savings of 4% per annum, which equated to £12million at Frimley Park NHS Foundation Trust.  The acquisition of Heatherwood and Wexham Park Hospitals NHS Foundation Trust would allow for a reduction in back-room costs whilst delivering greater efficiencies, for example in purchasing, and protecting front-line services.  Delivering efficiencies whilst maintaining quality was a major challenge for hospitals, but the acquisition would allow for better provision of doctors and nurses

·                     The Trust was currently negotiating with the Department of Health to write off the existing debt at Heatherwood and Wexham Park NHS Foundation Trust and invest capital in the infrastructure of Wexham Park Hospital, including a refurbishment of A&E, an upgrade of maternity services and addressing a backlog of maintenance issues.  The proposal for the Heatherwood hospital site was to develop and refurbish it as a modern elective surgery unit, and this too would require new funding.  It was intended that the acquisition could be used as an opportunity to secure funding to improve the facilities at Wexham Park Hospital and provide new diagnostic equipment. 

·                     The proposed acquisition was a very complex procedure that would need the agreement of both Councils of Governors, particularly as it would, in effect, mean the dissolution of the Council of Governors at Heatherwood and Wexham Park NHS Foundation Trust.  Frimley Park NHS Foundation Trust was keen to progress and conclude negotiations with the Department of Health, with the acquisition completed in the autumn if possible.  There were no proposed changes to services so there was no requirement to undergo a public consultation, but the proposals had been brought to the  ...  view the full minutes text for item 7.

To consider:

a)                  The results of the Care Quality Commission’s 2013 survey of adult inpatients for Frimley Park, Royal Berkshire and Heatherwood & Wexham Park Hospitals NHS Foundation Trusts.

b)                  The current information from the NHS Choices website, for the NHS Foundation Trusts providing most NHS services to Bracknell Forest residents.

c)                  The perspective of the Bracknell and Ascot Clinical Commissioning Group on the quality of patient care at Frimley Park, Royal Berkshire and Heatherwood & Wexham Park Hospitals NHS Foundation Trusts.

The report asked the Panel to review the latest inpatient survey results for the three hospital trusts, as well the current information from the NHS Choices website for the NHS Foundation Trusts providing most secondary NHS services to Bracknell Forest residents.  Sarah Bellars, Director of Nursing of Bracknell and Ascot Clinical Commissioning Group, attended the meeting to address the Panel and answer questions.

Sarah made a number of points, including the following:

·                     Sarah explained that she was actively involved in monitoring the quality of the Provision at Frimley Park Hospital, and that part of this role involved robust conversation where necessary.  There were currently no significant concerns.  The incidence of MRSA was higher than ideal, but Sarah had met with the Director of Nursing at the hospital and a comprehensive plan, including a ‘back to basics’ approach, had been put into place to address this.

·                     There were currently a number of concerns regarding Heatherwood and Wexham Park Hospitals.  It had been necessary to issue Contract Query Notices in more than one area, including A&E and stroke prevention, as a result of under-performance against targets for a significant period of time.  A particular issue was the recruitment of staff in general, and in particular substantive leaders.  A number of the leaders were in interim posts that would be ending in the next few months, and this could cause problems for management capability.  However, if the proposed acquisition of the Trust by Frimley Park Hospital NHS Foundation Trust was completed successfully this would help address this issue.  If the acquisition did not go ahead, that would be a major concern for the CCG.

·                     The Royal Berkshire Hospital Trust was currently facing some financial challenges, as well as a high turnover in senior staff and some recently identified issues with maternity provision. There were also concerns regarding diagnostic waiting times and storage of medical records.  The CCG had confidence in the recently appointed Chief Executive of the RBH.

The Chairman asked for further details of when stroke specialisation would be available, and whether it was a challenge to provide the service that the Trusts would like to in an increasingly challenging financial climate.

It was reported that the issues with stroke care had not been entirely resolved, but that this would be receiving attention.  It was agreed that the financial climate was very challenging as the Trusts were required to save £12million each year, so even providing the same service as the previous year would result in a loss.  However, consideration was being given to increasing revenue from other lines of income.

The Vice-Chairman asked for clarification of what was meant by ‘back to basics’.

It was explained that this was about reminding staff of why certain actions were so important, for example cleaning skin before inserting a cannula, when they were juggling a number of priorities.

The Panel noted that the end-of-life care provided at Frimley Park Hospital and the Royal Berkshire Hospital was very good, and asked  ...  view the full minutes text for item 8.

To adopt the Protocol between the Health & Wellbeing Board, Healthwatch Bracknell Forest and the Health Overview & Scrutiny Panel, as recommended by the Health and Wellbeing Board.

The Panel considered a report asking them to adopt a protocol between the Health and Wellbeing Board, Healthwatch Bracknell Forest (HWBF) and the Panel.  The report stated that the protocol had already been adopted by the Health and Wellbeing Board, the Minutes of which were attached to the report, and by HWBF.  A copy of a Minute recording agreement of a protocol between the Panel and HWBF was also attached, but the report noted that the new protocol subsumed the wording agreed in October 2013.

The Director of Adult Social Care, Health and Housing stated that the protocol aimed to add a degree of clarity to interactions between the three bodies.  It would, however, be kept under review to ensure that it was working in practice.  It was proposed by the Chairman, seconded by Councillor Thompson and carried that the Protocol be adopted.

To consider the parts of the Quarter 4 2013/14 (January to March) quarterly service report of the Adult Social Care, Health and Housing department relating to health.

Please bring the previously circulated Quarterly ServiceReport to the meeting.  Copies are available on request and attached to this agenda if viewed online.

The Panel was asked to consider the parts of the Quarter 4 2013/14 (January to March) quarterly service report of the Adult Social Care, Health and Housing department relating to health.

The Director of Adult Social Care, Health and Housing reported that the authority had worked closely with NHS partners on the creation of the Urgent Care Centre, and  continued to work closely with the Clinical Commissioning Group to provide a range of services, and in particular with Berkshire Healthcare Trust.  The largest of these contracts was for the provision of sexual health services.  This service had been recently reviewed, and this had resulted in Bracknell Forest maintaining the current service provider, Berkshire Healthcare Trust, on a block contract rather than a tariff-based service. The Public Health function had now been with the Council for one year, and it had settled in very well. For example, there had been national recognition for Bracknell Forest’s work concerning alcohol consumption. The annual report of Public Health would be presented to members.

With regard to looking forward, the Panel was informed that priorities would be informed by the Health and Social Care Act and national targets set out in the Better Care Fund, three out of five of which related to social care.  It was reported that older people wanted to live in their own home, supported by social care, and targets included avoiding emergency admissions and people still at home ninety-one days after discharge into intermediary care.  The health and social care economy was a very complex one to work within, and it had been necessary to reconsider the ways in which community support was offered, for example to reflect patients choosing Frimley Park hospital more frequently.

The Panel was advised that the budget would continue to be challenging, particularly as it was a demand-led service.  Bracknell Forest had an increasingly older population and, although this was still lower than neighbouring authorities, the rate of growth of this section of society was significantly higher than in other areas.  This also brought the associated challenge of supporting people with dementia.

In terms of adult social care, the priorities were prevention and intervention.  The department had produced three podcasts of local residents telling their story.  These could be made available to members of the Panel if they wished.

The Chairman raised the issue of unnecessary hospital admissions, and how these could be reduced to ease pressure on hospitals.  It was explained that Bracknell Forest Council funded a service that aimed to reduce unnecessary overnight stays.  In 95% of cases someone could be with the patient within two hours.  In addition, people were living longer with more complex conditions, and demands on the healthcare service, as well as social care, would increase. It was essential to keep the person at the heart of health and social care services. The Director was currently leading, on behalf of all the Berkshire Unitary Authorities, on a concordat with Berkshire Healthcare Trust concerning mental health. A separate briefing session  ...  view the full minutes text for item 10.

To note the Bi-Annual Progress Report of the Assistant Chief Executive.

The Head of Overview and Scrutiny presented a report on Overview and Scrutiny Activity during the period December 2013 to May 2014.  The report set out details of the meetings that had taken and place and the items that had been considered for the Overview and Scrutiny Commission and Overview and Scrutiny Panels, as well as other overview and scrutiny issues.  The report was noted.

To consider scheduled Executive Key and Non-Key Decisions relating to Health.

The Panel noted Executive Key and Non-key decisions relating to health.

The Panel noted that its next meeting would be held at 7.30pm on 2 October 2014.