Agenda and minutes

There were no substitute members present.

DECIDED:    That the Minutes of the Meeting held on the 12^th September 2018 be approved as a correct record and signed by the Chair.

DECIDED:    That the Minutes of the Meeting of the Healthy Staffordshire Select Committee held on 3^rd December 2018 be noted.

There were none.

·         Disclosable Pecuniary Interests

·         Other Interests

(At least two clear days notice required, in writing, to the Proper Officer in accordance with Procedure Rule 15).

Questions to Councillor Ralphs from Councillor Pam Wood:

Q1.      Is the Council aware that the North Staffordshire Clinical Commissioning Group are block booking beds in nursing/care homes, in order to care for people who would normally be looked after on the two wards at Leek Moorlands Hospital? The two wards have now been ‘temporarily’ closed for fifteen months.

Is the Council also aware that several of the nursing/care homes currently being used by the CCG were rated as ‘requires improvement’ by the Care Quality Commission?

What steps is this Council taking to ensure that Staffordshire Moorlands residents are not being put at risk by the actions of the CCG?

Response:- “The Council has been very involved with the ongoing process of establishing the future of local health services for the Moorlands and I would like to pay tribute to the CCG and NHS England for accommodating me.

The CCG have a number of beds currently commissioned at the Haywood, Ward 4 at the Harplands and across various other nursing and residential homes.

The CCG have a robust clinical and quality monitoring process in place against all of the commissioned beds, including full GP wrap around and therapy cover. In addition, all homes are subject to quality monitoring visits on a regular basis,  overseen by the CCGs quality team and flow is managed through the beds by the Track and Triage team with clinical and social care oversight.

All homes are also monitored by the safeguarding team linked to the relevant Local Authority and and the CCG have no concerns regarding the homes that beds are currently commissioned from. The CQC ratings are an indication of areas for improvement and each home has a robust action plan in place which is managed via the Local Authority with a multi-agency approach to review across health and social care. This local intelligence is utilised to spot any day to day issues with support in place, if required.

The pre consultation business case outlines the  proposed model of commissioning care home beds as part of option 6 which includes how the CCG would procure and manage beds including the approach to quality management and contracting.”

In response to this, Councillor Pam Wood re-iterated her concerns in relation to the quality of care provided by care homes and felt that this system didn’t  continually improve patients’ care.

Councillor Ralphs advised that members should look to the future and respond to the current consultation exercise.

Q2.There appears to be a great deal of confusion regarding the current system used by Leek GPs for taking blood samples. Apparently, some patients can access this service at their doctors practice whilst an increasing number are expected to go as far as Meir and Cobridge. Can we find out from the appropriate body exactly what is going on and why there is a need for some people to travel so far to benefit from what is such a simple procedure?

Response:- “I agree there is a lot of  ...  view the full minutes text for item 24.

The Panel heard detailed accounts of life with ME and how the illness debilitated patients. It was also brought to the attention of the Panel that there was very little support available to patients, minimal funding was allocated for research and that some medical professionals refused to accept that it was a medical condition. Members also heard how the parents of a child diagnosed with ME had been accused of fabricating the illness. The representatives advised members that they had set up an informal group which met at Meerbrook Village Hall, which gave the opportunity for patients and their carers to share information and experiences.

Members thanked the representatives for the informative and moving accounts of the condition. Discussion took place around various examples of children with ME and how worrying it was that parents were accused of fabricating the illness. All were in agreement that more support and understanding of ME was needed. A request was made to the Officers from the CCG for a specialised clinic to be made available in the area.  Dr Fawcett explained that the CCG was reliant on specialist services which could be difficult to access and that it wasn’t possible to commission regional specialists in local centres. 

DECIDED: That a request be made to the CCG for a local ME clinic to be set up in the Moorlands.

Liz Johnson – Service Manager, provided the Panel with an overview of the services provided by Changes Health and Wellbeing. The organisation had provided support for those in mental distress for 30 years. The free sessions ran weekly for 2 hours and were facilitated by local people which had been adequately trained. Unfortunately, due to funding, there was a disparity of services between the areas. In Stoke on Trent, a more comprehensive range of services were available.

It was suggested that services should be provided in the local schools. The Officers advised that Wellness Programmes were held twice a year at Westwood and Leek High School. It wasn’t possible to expand these services without additional funding.

The experience of a Volunteer Co-ordinator, which in their opinion had not received adequate training, was shared by a Councillor with the Panel. It was mentioned that the number of volunteers had reduced in the last couple of years and that governance was very important. It was also felt that there was a lack of support for young carers in the area and that patients were disadvantaged in the Moorlands due to the distances they had to travel to access Child and Adolescent Mental Health Services.

In response, the Officers advised that they were not aware of this person, volunteers received monthly supervision and training and were sorry that that this person felt unsupported in their role. There hadn’t been a noticeable reduction in volunteers for this area and shared the frustration around the current level of mental health support provided.

The Chair passed on her thanks to the Officers for attending the meeting.

DECIDED: That the update be noted.

The Panel gave its consideration to a presentation, which was introduced by various representatives from the CCG. The following subject areas were included:-

·         Aims and Objectives

·         The Journey so Far

·         Reasons for Change

·         Aims of the Proposed Model

·         The Proposed Model of Care

·         Principles of the New Model

·         Integrated Care Hubs

·         Community Hospital and Care Home Beds (Options 1 to 6)

It was explained to the Panel that the 132 beds referred to within the options were a base line figure which could be flexed up or down to meet need.  Option 6 was the preferred option for the CCG, as it would join up services, improve care of frail and elderly, get the best from the workforce and overall, be sustainable.

Discussion took place around the refurbishment/redevelopment of Leek Moorlands Community Hospital, Integrated Care Hubs, Home First, hospital re-admissions, quality of Care Homes and how they were monitored.

Some members asked for clarity around the scoring system for the options and the interpretation of the statistical data. Marcus Warnes explained that a national scoring system was used, the West Midlands Clinical Senate had been involved and NHS England was satisfied with the criteria set out.

Queries were raised around all of the associated costs in relation to care home beds. The Officers agreed to provide one table with this information after the meeting. It was also confirmed that any capital expenditure required would not be funded by private finance initiatives.

To summarise, the following conclusions were made by members of the Panel:-

•           One Integrated Care Hub for the whole of the Staffordshire Moorlands would be inadequate.

•           Due to a lack of confidence in the level of care provided to patients at home, members were concerned that the number of re-admissions to hospital would increase.

•           That option 6 (the preferred option) contained within the proposal, would not continually improve the quality of care for patients.

•           Concern that some of the NHS Commissioned beds would be located within Care Homes which were rated by the CQC as ‘required improvement’.

•           Residents from the rural areas of the Moorlands would be disadvantaged due to travelling distances to Care Homes. It was important for residents of the Moorlands to receive care at Care Homes within in the area.

•           Some members were of the opinion that the beds were retained at Leek Moorlands Hospital.

•           That the provision of Dementia Services in the Moorlands was paramount and that patients diagnosed with Dementia should not be placed in Care Homes to receive the necessary care which they required.

•           Concern around patients being discharged at night time to homes which they solely occupied.

•           Some members were pleased with the types of services which would be provided at the Care Hub in the Moorlands.

•           Clarification was required around the number of beds needed and interpretation of the statistical data in relation to numbers of patients.

DECIDED: That the presentation be received and the above points be noted.

Any additional items to be added to the Work Programme:-

i)          Chairman’s items;

ii)         Members items;

The Panel considered its Work Programme and agreed the items listed.

DECIDED: That the Panel’s Work Programme for 2018/19 be agreed