Agenda and minutes

To receive apologies for absence and to note the attendance of any substitute members.

The Panel noted the presence of the following substitute members:

Councillor Brossard for Councillor Baily

Councillor Davison for Councillor Kensall

To approve as a correct record the minutes of the meeting of the Health Overview and Scrutiny Panel held on 2 October 2014.

RESOLVED that the minutes of the Health Overview and Scrutiny Panel meeting held on 2 October 2014 be 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 under the Council’s Public Participation Scheme for Overview and Scrutiny.

To review and discuss with representatives of Bracknell Forest General Practitioners and NHS England (the commissioners of most General Practitioner (GP) services): the latest GP Patient survey results; the Care Quality Commission’s ‘Intelligent Monitoring’ ratings for Bracknell Forest GP practices; and national concerns regarding the capacity of GP Practices and the ease of obtaining GP appointments.

The Chairman welcomed, Sarah Bellars, Nursing Director Berkshire East Clinical Commissioning Group, Dr William Tong, Bracknell and Ascot Clinical Commissioning Group and Binfield GP Practice, Dr Martin Kittell, Bracknell and Ascot Clinical Commissioning Group and Forest End GP Practice and Helen Clanchy, Director of Commissioning NHS England, to the meeting to speak about the primary care service provided in Bracknell Forest.

Care Quality Commission Inspection of GP Surgeries

It was reported that to date 10 GP practices in the Borough had been subject to an inspection by the Care Quality Commission (CQC).  Four practices had received a grading of Good, four had been graded as Requiring Improvement.  The outcomes of two inspections were still awaited.

Analysis of the inspection reports had found that GP surgeries were failing inspections in the following areas:

·         Record storage

·         Staffing requirements e.g. Had DBS checks and references been obtained

·         Monitoring of infection control standards

·         Quality of service

·         Supporting staff e.g. One to ones and appraisals

·         Medicine dispensing had been raised as an issue in one surgery

It was stressed that further investigation had found that surgeries were complying with standards however evidence trails and records were not always being properly maintained and this had impacted on inspection outcomes.  The Berkshire East Clinical Commissioning Group was working with practices to resolve the issues that had been identified by the inspections.  All those practices which had been classified as requiring improvement had developed action plans and were working to deliver identified actions.

It was reported that the action plans and associated evidence would be submitted to the CQC for examination.  It was hoped that the CQC would be able to carry out a desktop review or inspection visit within the next six months.  The Clinical Commissioning Group was confident that all the surgeries would on re-examination be regarded as being good.

GP Satisfaction Surveys

The Panel considered the outcomes of the recent NHS GP Patient Survey and the CQC Intelligent Monitoring ratings of GP practices in the Borough. 

It was stressed that caution must be exercised when using the GP Patient Survey to make inferences about the quality of GP service provision due to the small sample sizes used and the fact that the survey did not take the socio-economic profile of patients or clinical outcomes into account.

Dr Kittell expressed disappointment with the outcomes of both the CQC inspection and the GP Patient Survey satisfaction ratings that Forest Park GP Surgery had received.  The Panel was informed that the practice’s designated area covered a high proportion of young people and a high proportion of patients with mental health problems both factors which impacted on satisfaction levels. 

Initial plans to expand the building occupied by Forest End Surgery had fallen through however the available space had been re-organised and the surgery now had access to an additional consulting room.  The surgery had also been approved to become a GP Training Practice and two trainee GPs had now been employed.  It was stressed that surgeries had to pass  ...  view the full minutes text for item 29.

To receive a progress update on the work of the Bracknell Forest Health and Wellbeing Board.

The Executive Member for Adult Social Care, Health and Housing, gave a presentation in respect of the Health and Wellbeing Board which he chaired.

The Health and Wellbeing Board was a statutory partnership body established to bring agencies together to work to improve health outcomes and reduce health inequalities of the Borough’s residents. 

It was reported that key areas of work for the Board over the past twelve months had been the publication of an easy to use new Joint Strategic Needs Assessment, the adoption of the Joint Health and Wellbeing Strategy, the development of a new and innovative approach to prevention which had been shortlisted for an LGC award and was recognised nationally as an example of good practice, the submission of a successful bid to the Better Care Fund and the initiation of work to re-commission Child and Adolescent Mental Health Services (CAMHS) in the Borough.

It was noted that initial work to re-commission CAHMS had resulted in the Clinical Commissioning Group increasing funding to both Tier 3 and the interface between Tiers 2 and 3 and work was taking place to further develop and improve the service.  The Youth Parliament had also commissioned a piece of work to map mental health services from the perspective of young people and this would be used to further inform the Health and Wellbeing Board’s work in this area.

Key priorities for the Board over the coming year included a review of the Board’s membership and the way that it worked, the identification of new priorities that would feed into a refresh of the Joint Health and Wellbeing Strategy, establishing specific measurable priorities for the Board and the development of a joint approach to communications. 

The Board was well supported by all agencies involved and work was taking place to engage with the area’s Acute Healthcare Trusts.  It was hoped that the review of the Board’s membership and way of working would provide opportunities to involve a wider range of agencies with the Board’s work however it was stressed that the Board remained action focused and did not become a ‘talking shop’.

It was acknowledged that the Board operated within a complex landscape that often had multiple commissioners working to commission a single service.  However, involved organisations recogised their own role in improving health and wellbeing.

To review the Council’s budget proposals for health in 2015/16, and plans for future years.

The Panel received a report setting out the draft budget proposals for 2015/16.

It was noted that the Public Health budget was almost entirely funded through a ring-fenced grant of £3.049million with an additional contribution of £100,000 from the NHS Money for Social Care Transfer.

The Panel noted that in a change from previous years, the Drug and Alcohol Action Team would be fully funded from the Public Health Grant in 2015/16 however the amount of the Team’s budget would remain unchanged.

The Panel noted the budget proposals.

To consider the parts of the Quarter 2 2014/15 (July to September) quarterly service report of the Adult Social Care, Health and Housing department relating to public 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 considered the sections of the Adult Social Care, Health and Housing Department’s Quarter 2 (July to September 2014) Quarterly Service Report (QSR) relating to health.

It was reported that the Council’s submission to the Better Care Fund had been approved in December and that work was taking place to develop and progress the eight projects proposed within the submission which included falls prevention and intermediate care

Arising from the Panel’s questions and comments the following points were noted:

·         It was agreed that a summary of the nature of compliments received would be included in future QSRs

·         It was clarified that the Bridgewell Intermediate Care Centre was being relocated into new premises that would not only enable it to expand to take in more residents in the coming years but also enable the onsite provision of related services for example the Falls Clinic

·         It was reported that although there was pressure on teams to expedite the discharge of patients from hospital this was well managed and the Department placed an emphasis on putting care packages in place that would help people continue to live in their own homes rather than having to move into residential or nursing care.

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

The Panel noted the forthcoming Executive Key and Non Key decisions relating to health.

It was clarified that the Joint Commissioning Strategy for Carers would look at the range of services being offered to ensure that they met the needs of carers.

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

The Panel noted the bi-annual progress report setting out overview and scrutiny activity during the period June to November 2014.

To propose items for inclusion in the Panel’s work programme for 2015/16.

The Panel considered a report setting out proposed items for inclusion in the Overview and Scrutiny work programme for 2015/16.

It was agreed that a review of the mechanisms for the allocation and commissioning of GP surgeries to match long-term growth in the Borough’s population would be added to the review programme.

The next scheduled meeting of the Health Overview and Scrutiny Panel will take place on 12 March 2015.

It was noted that the next scheduled meeting of the Health Overview and Scrutiny Panel would take place on 12 March 2015 at 7.30pm.