Agenda and minutes

Scrutiny Health & Social Care Sub-Committee
Tuesday, 18th December, 2018 6.30 pm

Venue: Council Chamber, Town Hall, Katharine Street, Croydon CR0 1NX

Contact: Simon Trevaskis
02087266000  Email: simon.trevaskis@croydon.gov.uk

Items
No. Item

42/18

Minutes of the Previous Meeting pdf icon PDF 101 KB

To approve the minutes of the meeting held on 20 November 2018 as an accurate record.

 

Minutes:

The minutes of the meeting held on 20 November 2018 were agreed as an accurate record.

The Chair confirmed to the Sub-Committee that following the previous meeting a letter had been sent to King’s College Hospital NHS Trust to register the concerns of the Sub-Committee regarding the closure of the Community Dental Service in New Addington.

The Director of Public Health advised the Sub-Committee that the Trust should have informed her prior to any change being made to the service, which had not been the case. As such she was rigorously investigating how this had happened and also looking to investigate options with the Trust for the re-provision of the service in the local area.

43/18

Disclosure of Interests

In accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, Members and co-opted Members of the Council are reminded that it is a requirement to register disclosable pecuniary interests (DPIs) and gifts and hospitality to the value of which exceeds £50 or multiple gifts and/or instances of hospitality with a cumulative value of £50 or more when received from a single donor within a rolling twelve month period. In addition, Members and co-opted Members are reminded that unless their disclosable pecuniary interest is registered on the register of interests or is the subject of a pending notification to the Monitoring Officer, they are required to disclose those disclosable pecuniary interests at the meeting. This should be done by completing the Disclosure of Interest form and handing it to the Democratic Services representative at the start of the meeting. The Chair will then invite Members to make their disclosure orally at the commencement of Agenda item 3. Completed disclosure forms will be provided to the Monitoring Officer for inclusion on the Register of Members’ Interests.

 

Minutes:

There was none.

 

44/18

Urgent Business (if any)

To receive notice of any business not on the agenda which in the opinion of the Chair, by reason of special circumstances, be considered as a matter of urgency.

 

Minutes:

The Chair advised the Sub-Committee that he had agreed to allow the progress report from the South London and Maudsley NHS Foundation Trust to be considered as an urgent item to ensure that the update was provided in line with the Sub-Committee’s recommended timeframe set at their meeting on 28 September 2018.

45/18

South London & Maudsley NHS Foundation Trust - Progress Report pdf icon PDF 906 KB

At the Health & Social Care Sub-Committee meeting on 25 September 2018 it was agreed to recommend a request for an update in December 2018 on the actions that have been put in place by the South London & Maudsley NHS Foundation Trust in response to the CQC Findings.

 

The Chair has agreed to take this item as an urgent matter of business to ensure the timescale specified by the Sub-Committee in its recommendations is met.

Minutes:

Beverley Murphy, the Director of Nursing at SLaM and Doctor Faisil Sethi, the Interim Service Director for the Croydon Executive Team of SLaM, were in attendance at the meeting to provide an update on the actions being implemented in response to the findings from a Care Quality Commission (CQC) inspection earlier in the year.

From the presentation the following information was noted:-

·         An overview of the management structure for the team responsible for inpatient and community services in Croydon and Behavioural & Development Psychiatry (BDP) was provided. SLaM provided reassurance to the Sub-Committee that the right team was now in place to deliver improvement going forward. 

·         An Action Plan had been developed which focussed upon achieving the ‘must do’ recommendations within the CQC report. This included achieving a consistent standard of care across the organisation with work also needed to address concerns regarding the Ward Directorates.

·         Weekly meetings chaired by the Chief Executive of SLaM had been set up to account for the implementation of the Flow Plan which had been created to improve the flow of patients through the service to discharge.  The short term results had been encouraging with a reduction in the amount of people waiting in A&E, but it was essential to ensure that this good work continued moving forward.

·         A Delivery Board chaired by the Director of Nursing, which met once a fortnight, had been set up to provide oversight of the improvement plans being delivered as a result of the CQC inspection.  There were six improvement plans in place, each with actions relating to their respective areas. The plan for Croydon included 194 separate actions which varied from the straight forward to multi layered, detailed actions. The Delivery Board focussed its attention upon those actions that were not on track.

·         From the 194 actions set out within the improvement plan for Croydon, highlights included having the Directorate Senior Management Team in place, continuous improvement around the recruitment and retention of a high quality and skilled workforce, continued improvement to address issues relating to patient flow and continued improvement in mental health transfers from emergency departments.

Following the presentation, members of the Sub-Committee were given the opportunity to question the representatives from SLaM. The first question concerned how SLaM commissioned services, with it confirmed that this would depend on the type of service being commissioned. Forensic and neurodevelopmental services would be commissioned on a regional or national level by NHS England, while others would be on a more local Croydon basis.

In response to a question concerning how data for mental health assessments was tracked, it was confirmed that daily reports were prepared for the Executive Management team. This information was also regularly reported to both the Board and the Quality Committee.

There was a concern raised that the work to improve patient flow was too management focussed and as such it was question whether improvements were being cascaded to frontline staff. It was confirmed that this was an important issue for SLaM with mechanisms  ...  view the full minutes text for item 45/18

46/18

Winter Preparedness 2018-2019 pdf icon PDF 2 MB

To receive an update from the Executive Director for Health, Wellbeing & Adults and representatives from the Croydon University Hospital NHS Trust and the Croydon Clinical Commissioning Group on their preparations to manage service demand this winter.

Minutes:

The Sub-Committee had invited representatives from the Clinical Commissioning Group (CCG) and the Croydon Health Service (CHS) along with representation from the Adult Social Care team from the Council to the meeting to provide an update on their preparations for the winter period. The following people were in attendance for this item:-

·         Andrew Eyre – Accountable Officer for the CCG

·         Stephen Warren – Director of Commissioning for the CCG

·         Matthew Kershaw – Chief Executive for CHS

·         Paul Richards - Head of Adult Mental Health Substance Misuse for Croydon Council

During the introduction to the report it was emphasised that plan for winter had very much focused on whole system working with a view to keeping people well and out of Accident & Emergency (A&E) where possible. The plan had been developed jointly by the CCG, CHS and the Social Care team at the Council. A key challenge to the delivery of the plan was the need to manage an increasing demand for services and as such it focused on the following areas:

·         Strengthen Governance arrangements.

·         Developing and delivering out of hospital initiatives.

·         Working to improve capacity within services through the improved maintenance of patient flow.

·         The launch of the new A&E facility at Croydon University Hospital.

Work to date on the plan included:-

·         The recommissioning of urgent care services through the provision of three GP hubs, including the GP Extended Access Hub to provide additional appointments.

·         Continued work on patient education to direct away from A&E towards more appropriate services such as GPs and pharmacists.

·         The Winter Communications Plan included a Flu Campaign which raised awareness of the Flu Vaccination programme, with a particular focus on vulnerable groups and frontline NHS staff.

·         The new Emergency Department opened on 2 December 2019 and was already delivering benefits such as improved ambulance handover times and improved escalation capacity and flexibility within the service.

·         Mental Health Initiatives included multi-agency discharge events focussed on reducing the length of stay in the Emergency Department, with additional beds for mental health patients commissioned with the East London Foundation Trust.

Key challenges to the delivery of the plan were:

·         The recruitment and retention of the staff, which remained a problem across London, particularly in paediatric care. However there had been an improvement since September with a reduction in the number of unfilled shifts in the Emergency Department.

·         Patient discharge continued to be an issue, with work underway to improve discharge processes including enhancing the discharge team through the recruitment of a single manager working across the health service and social care service to improve the focus on discharge.

·         There was a continued focus on long stay patients, with ‘stranded’ patients remaining a significant challenge. There were also a significant amount of patients from other boroughs which increased the complexity when discharging

·         The Council had been given funding of £1.4m to assist with winter pressures including the delayed transfer of care, market stabilisations and LIFE demand.

·         There was further opportunity to develop the GP Huddles which  ...  view the full minutes text for item 46/18

47/18

Healthwatch Croydon

To received an update from the Manager of Healthwatch Croydon on their current activities.

Minutes:

Gordon Kay, the Manager of Healthwatch Croydon provided an update for the Committee on their recent activities. It was confirmed that application period for new members of the Board had recently closed, with the selection process underway. It was hoped that the new Board Members would be in place by the end of January to begin business planning for April.  Mr Kay thanked those Members who had helped to raise awareness of the vacancies.

48/18

South West London and Surrey Joint Health Overview and Scrutiny Committee

To receive an update from the Chairman and/or the Vice Chairman on the recent meetings of the Joint Health Overview and Scrutiny Committee.

Minutes:

The Vice-Chair provided an update on a recent meeting of the South West London and Surrey Joint Health Overview and Scrutiny Committee, at which the review on the future of Accident & Emergency and Maternity services at Epsom, St Helier and Sutton Hospitals was considered. A key concern for Croydon would be the closure of these services at St Helier Hospital, as projections had indicated that this would significantly increase demand at the Croydon University Hospital.

The Chairman also provided an update from the meeting of the Pan London Joint Health Overview and Scrutiny Committee Forum, which had met recently. The discussion at the meeting had focused on the ongoing issues around staffing in the NHS across London, with an emphasis on looking at new ways for different organisations to work together.

49/18

Exclusion of the Press and Public

The following motion is to be moved and seconded where it is proposed to exclude the press and public from the remainder of a meeting:

 

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

 

Minutes:

This motion was not needed.