Agenda and minutes

Health and Adult Social Care Scrutiny Committee
Wednesday, 27th November, 2019 10.30 am

Venue: County Hall, Chichester

Contact: Rob Castle on 033 022 22546  Email:  rob.castle@westsussex.gov.uk

Webcast: View the webcast

Items
No. Item

25.

Declarations of Interest

Members and officers must declare any pecuniary or personalinterest in any business on the agenda. They should also make declarations at any stage such an interest becomes apparent during the meeting. Consideration should be given to leaving the meeting if the nature of the interest warrants it.  If in doubt please contact Democratic Services before the meeting.

Additional documents:

Minutes:

25.1   In accordance with the code of conduct the following interests were declared: -

 

·         Mr Atkins in respect of item 4, Responses to Recommendations, as a debt coach in Worthing

·         Mr Turner in respect of item 6, West Sussex Winter Plan and item 7, South East Coast Ambulance Service Update, as a locum pharmacist who uses the NHS 111 referral system

·         Mr Boram in respect of item 8, Housing Related Support, as a member of Adur District Council

·         Mrs Bridges in respect of item 8, Housing Related Support, as a member of Adur District Council

·         Ms Sudan in respect of item 8, Housing Related Support, as a member of Crawley Borough Council

·         Dr Walsh in respect of item 8, Housing Related Support and item 9, Local Assistance Network Task & Finish Group, as leader of Arun District Council

·         Cllr McGregor in respect of item 8, Housing Related Support, as a member of Adur District Council

26.

Minutes of the last meeting of the Committee pdf icon PDF 174 KB

The Committee is asked to agree the minutes of its meeting held on 26 September (cream paper).

Additional documents:

Minutes:

26.1 Resolved – that the minutes of the meeting held on 26 September 2019 be approved as a correct record and that they be signed by the Chairman.

27.

Responses to Recommendations pdf icon PDF 129 KB

The Committee is asked to note the responses to recommendations made at its 26 September meeting from the Cabinet Member for Adults & Health.

Additional documents:

Minutes:

27.1 Resolved – that the Committee notes the responses.

28.

Forward Plan of Key Decisions pdf icon PDF 226 KB

Extract fromthe ForwardPlan dated 15 November.

 

Anextract fromanyForwardPlan publishedbetween the date of despatchof the agenda and the date of the meetingwill be tabled at the meeting.

 

The Committee is asked to consider whetheritwishes to enquireinto any of the forthcoming decisions withinits portfolio.

Additional documents:

Minutes:

28.1   A query regarding the effectiveness of peer mentoring and support in relation to the proposed decision ‘Contract for Provision of Children, Young People and Adults, who use Alcohol and / or Drugs, their Families and Carers extension’ to be taken up by the Chairman.

 

28.2   In the proposed decision ‘Commissioning of Care and Support at Home’ the difference between those eligible for social care in general and those eligible for social care provided by the Council would be made clear.

 

28.3   Resolved – that the Committee notes the Forward Plan of Key Decisions.

29.

West Sussex Winter Plan pdf icon PDF 123 KB

Report by West Sussex Clinical Commissioning Groups.

 

The report outlines the winter plans for the health and social care systems across West Sussex.

Additional documents:

Minutes:

29.1   The Committee considered a report by the West Sussex clinical commissioning groups (CCGs) which was introduced by Pennie Ford, interim Executive Managing Director representing the West Sussex CCGs who highlighted the following points: -

 

·         The objective of the winter plan was to keep patients and staff safe during times of extra pressure, using a partnership approach across the health and social care systems and to meet demand, including surges of activity

·         All the local accident & emergency (A&E) delivery boards had been involved in developing the plan which had then been approved by internal scrutiny, governing bodies, providers and the Health & Wellbeing Board and had gained the assurance of NHS England and NHS Improvement

·         The plan was constantly monitored and reviewed

·         The key points were lessons from previous years, main service changes, actions for winter and focussing on caring for people at home

·         Key initiatives were operating the ‘Home First’ model, co-locating urgent treatment centres with A&E departments, encouraging flu vaccinations and a refreshed communications campaign that included encouraging people to get their prescriptions in good time

·         Risks and challenges were national and local pressures on the system -  West Sussex acute hospitals were performing well compared to others around the country

·         Access to GPs had been improved to cope with large numbers of expected patients that present themselves to A&E

·         Ambulance conveyance patterns had been reviewed

·         NHS England was assisting to find best practice solutions to the problem of people staying in hospitals longer than necessary

 

29.2   Summary of responses to the Committee’s questions and

comments: -

 

·         There were cold weather business continuity plans that included using four wheeled drive vehicles to transport patients and staff

·         Sussex Community NHS Foundation Trust encouraged its staff to go to the nearest Trust location if they couldn’t get to their usual place of work

·         The Council was aware of care providers’ winter plans and had its own detailed plans for social care teams

·         The flu vaccination take-up rate for staff at Western Sussex Hospitals NHS Foundation Trust was currently 52% against a target of 80% - social media was used to encourage staff to be vaccinated and there were weekend and evening opportunities to make this easier

·         Under NHS contracts it was not compulsory for staff to be vaccinated against flu

·         Flu vaccination rates for the over 65s and vulnerable groups in West Sussex was above average – in the Coastal West Sussex area the rate had improved from 44% last year to 62.7% at present

·         There were local and international recruitment campaigns with temporary staff being used when needed

·         The vacancy rate for nursing staff was 10% - ACTION: Pennie Ford to provide the Committee with the vacancy rates for ancillary and medical staff across the Trusts treating West Sussex residents

·         Additional nurses would support the extra adult patient beds to be introduced for winter

·         Acute hospitals had mental health liaison teams to help with an increase over winter of admissions of patients with mental health problems  ...  view the full minutes text for item 29.

30.

South East Coast Ambulance Service Update pdf icon PDF 2 MB

Report by South East Coast Ambulance NHS Foundation Trust which updates the Committee on progress made by the Trust since the November 2018 Care Quality Commission inspection that judged it required improvement.

 

The report also includes an update on 999 performance.

Additional documents:

Minutes:

30.1   The Committee considered a report by South East Coast Ambulance Service NHS Foundation Trust (SECAmb) that was introduced by Joe Garcia, Executive Director of Operations SECAmb who told the Committee: -

 

·         As well as a Care Quality Commission (CQC) rate of ‘Good’ overall, SECAmb had been judged as ‘Outstanding’ for being well-led in caring and the control room

·         There had been changes to the leadership and senior management to aid improvement

·         Whilst there were a lot of measures in place to improve performance, rural areas were still a challenge

·         SECAmb wanted to strengthen the role of community first responders

·         Staff numbers had increased by nearly 200 meaning that there were 6,000 more operational hours per week versus the same time last year

·         The longest hospital handover delays were at St Richard’s hospital, Chichester based on lost hours per incident> 30 minutes turnaround

·         From 25th November staff have access to an app that would help them find treatment pathways for patients whilst with them

·         Onecall helped enhance patient outcomes

·         There was focus on more local urgent care hubs

·         Response times for lower category incidents were challenging as the focus was on meeting the highest life-threatening category calls

·         An unmarked street triage car had been introduced in Crawley to help with mental health patients emergency response.

·         The Tangmere ‘Make Ready’ centre was being developed and would help with quicker response times and more efficient operation

 

30.2   Summary of responses to the Committee’s comments and

questions: -

 

·         Paramedics still went through a three year degree course – 140 new paramedics had been employed since August

·         Morale seemed high in stations with good feedback received on wellbeing procedures - this and the outstanding judgement for well-led indicated that the bullying problem was being addressed

·         There has been a 7% increase in service demand due to an increase in access routes, groups of GP surgeries closing at the same time, increased older population, increased incidents of chest pain and respiratory problems in young adults

·         The ‘Demand and Capacity Review’ set a target for whole time staff predicated on anticipated growth, not actual growth

·         Staffing levels are 245 below target but 41 whole time equivalents (at time of report) ahead of trajectory – shortfalls are made up by using staff overtime and private providers

·         All sub-contractors went through a rigorous selection process and had to have passed CQC inspection with staff vetted and identified as working for SECAmb

·         No further Make Ready centres were planned for West Sussex in addition to those at Worthing and Tangmere. Ambulance Community Response Posts were used to station ambulance crews awaiting an incident, including one in the north of the county near the border with Surrey to take advantage of the Guildford centre

·         SECAmb uses community first responders to support  reaching people in rural areas as quickly as possible

·         There was a pilot scheme in the Horsham and Mid Sussex area whereby paramedics rotated working in GP surgeries and the ambulance service.

·         Staff at the wellbeing hub in Crawley  ...  view the full minutes text for item 30.

31.

Housing Related Support pdf icon PDF 68 KB

Report by the Executive Director Adults and Health regarding Housing Related Support contracts.

Additional documents:

Minutes:

31.1   The Committee considered a report by the Executive Director Adults and Health which was introduced by Amanda Jupp, Cabinet Member for Adults and Health and Mark Dow, Head of Strategic Housing.

 

31.2 Amanda Jupp told the Committee that: -

 

·         A lot of hard work had been done with the coalition of providers and district and borough councils through a task & finish group (TFG) to improve things for the homeless

·         After the decision to reduce funding for housing related support, Crawley Open House had attracted funding from Homes England to move its resource and day centre to a separate building from the hostel which would be residential only

·         The County Council had attracted funding from the Department of Communities and Local Government and from Public Health England specifically for Turning Tides, Worthing

·         Special thanks go to Mark Dow for his hard work in this area

 

31.3   Mark Dow highlighted the following: -

 

·         The County Council was decommissioning red contracts (providers such as social landlords were now supplying these services) and recommissioning green contracts whilst three amber contracts had secured funding from the district/borough councils for co-commissioning and procuring with the County Council –
ACTION: Mark Dow to provide the Committee with a list of organisations that still received housing related support

·         Procurement of new contracts would begin in January reflecting local needs with soft market testing establishing that the £750k available per year would be sufficient

 

31.4   Summary of responses to the Committee’s comments and

questions: -

 

·         The coalition of providers and district/borough councils were aware this update report was being produced but did not ask to contribute to it

·         The Vice Chairman in his capacity of Leader of Arun District Council repoirted that Arun District Council had made an extra £1m available for helping the homeless as a result of the County Council’s reduction in funding for housing related support, including purchasing accommodation, and that Turning Tides had opened an extra winter shelter in Littlehampton

·         The TFG would continue to meet to monitor the situation and look at other areas of homelessness such as the increasing need for temporary accommodation

·         Pressures on housing authorities came from duties as a result of the Homelessness Reduction Act and the affordability of public and private rents

·         Public Health England had granted Western Sussex Hospitals NHS Foundation Trust £387k for homeless people presenting at A&E

·         Sussex Partnership NHS Foundation Trust had appointed clinical discharge co-ordinators to work with district/borough councils’ housing officers to establish the best pathways for mental health patients being discharged from hospital – housing providers and social care teams also needed to be involved to help those with complex needs find the right type of accommodation

·         A housing strategy was needed for all vulnerable groups

·         The County Council helped young homeless people through ‘Move On’ accommodation

 

31.5   Resolved – that the Committee asks that: -

 

  1. Its business planning group considers how this issue should be monitored by the Committee going forward
  2. That an update from the task & finish  ...  view the full minutes text for item 31.

32.

Local Assistance Network Task & Finish Group pdf icon PDF 97 KB

Letter from the Chairman of the Task & Finish Group to the Cabinet Member for Adults and Health.

 

The letter informs the Cabinet Member of the Task & Finish Group’s thoughts and recommendations.

Additional documents:

Minutes:

32.1   The Cabinet Member for Adults & Health reported that she was reflecting on the recommendations made by the Local Assistance Network Task & Finish Group and that the decision on the Local Assistance Network would be taken soon.

 

32.2   Resolved – that the Committee notes the letter from the Local Assistance Network Task & Finish Group outlining its thoughts and recommendations to the Cabinet Member for Adults & Health.

 

33.

Date of Next Meeting

The next meeting of the Committee will be held on 15 January at 10.30 am at County Hall, Chichester.  Probable agenda items include:

 

·         Proposals to improve mental health services in West Sussex

 

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 30 December 2019.

Additional documents:

Minutes:

33.1   The next meeting of the Committee is scheduled for 10.30 on 15 January at County Hall, Chichester.