Agenda and minutes

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.

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

·        Cllr Belsey in relation to item 5a, Response to Recommendations, the response from Sussex Community NHS Foundation Trust, as a governor of Sussex Community NHS Foundation Trust

The Committee is asked to agree the minutes of the meeting held on 16 January 2019 (cream paper).

45.1   Resolved – that the minutes of the meeting held on 16 January 2019 be approved as a correct record and that they be signed by the Chairman.

Extract fromthe ForwardPlan dated 1 March.

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.

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

The Committee is asked to note the following responses: -

a) Sussex Community NHS Foundation Trust to recommendations made at the 15 November 2018 meeting.

b) The Cabinet Member for Adults and Health to recommendations made at the 16 January 2019 meeting.

c) South East Coast Ambulance Service NHS Foundation Trust to recommendations made at the 16 January 2019 meeting.

d) The clinical commissioning groups to recommendations made at the 16 January 2019 meeting.

e) Secretary of State for Health to recommendations made at the 16 January 2019 – to follow.

47.1   The Committee discussed the responses and was unhappy that performance data from South East Coast Ambulance Service NHS Foundation Trust had not been attached to its response and the assertion that the data could lead to misinterpretation.  The Committee also commented that there was lack of clarity in the response from the clinical commissioning groups.

47.2   Resolved – that the Committee

     i.        Notes the responses from Sussex Community NHS Foundation Trust and the Cabinet Member for Adults and Health

    ii.        Asks the Chairman to write to South East Ambulance Service NHS Foundation Trust requesting a representative to come to a future meeting of the Committee with performance data for West Sussex

  iii.        Asks the Chairman to write to the clinical commissioning groups requesting clarity of their understanding of comments made by the Secretary of State for Health at the Conservative Party Conference in 2018 regarding the future of community hospitals

Report by NHS England South East.

The report updates the Committee on the national public consultation exercise on the proposed Radiotherapy Service Specification and the final Service specifications for Radiotherapy services in England.

48.1   The Committee considered a report by NHS England South East (copy appended to the signed minutes) which was introduced by Fiona Mackison, Service Specialist, NHS England South East who told the Committee: -

·        Service specifications had been published in January 2019 for Adult External Beam Radiotherapy Services delivered as part of a designated network and Operational Delivery Networks for Adult External Beam Radiotherapy Services

·        Under the new services, treatment for rare cancers would be available closer to patients’ homes where possible

·        Trusts would be encouraged to work together and linacs (Linear Accelerators) would be available five days a week

·        Providers will sign a Memorandum of Understanding to agree how networks should be run

·        There will be agreed tumour treatment protocols across networks

·        It was hoped that travel times for patients will be reduced by having more treatment nearer where patients’ lived

·        The specifications did not stop the possibility of a satellite site at Chichester as recommended by the Cancer Alliance

48.2   Phil McNamara of the Surrey & Sussex Cancer Alliance told the Committee: -

·        The Alliance was concerned with population-based care giving people access to high quality radiotherapy

·        The Alliance had a productive Network Oversight Group meeting with The Royal Marsden NHS Foundation Trust and Imperial College Healthcare NHS Trust

·        The Alliance would chair the Group from April

·        Modernisation of services had begun

·        The Memorandum of Understanding should lead to clinicians working better together

·        The Group would push for two linacs at Chichester

48.3   Summary of responses to Members’ questions and comments: -

·        Service providers had been involved in developing the new strategy

·        It was thought unlikely that the Royal Marsden NHS Foundation Trust and Imperial College Healthcare NHS Trust would want West Sussex patients to travel to London for treatment as their capacity was already stretched

·        The Network Oversight Group had prioritised improved IT

·        NHS England South East was waiting for a provider to produce a business case to take on radiotherapy services in West Sussex – until this happened it was not possible to say when new services would be available

48.4   Resolved that – the Committee: -

     i.        Welcomes the support from the Surrey & Sussex Cancer Alliance to have two linacs sited at St Richard’s Hospital, Chichester

    ii.        Agrees that the Chairman should write to local NHS trusts to ensure that a business case to provide radiotherapy services in West Sussex is drafted as a matter of urgency and submitted to NHS England South East

  iii.        Asks that the Committee is kept regularly updated on progress towards implementation of the new services

Information report and presentation by Executive Director for Children’s, Adults, Families, Health and Education and Director of Adults’ Services.

49.1   The Committee considered a report by the Executive Director for Children, Adults, Families, Health and Education and the Director of Adults’ Services (copy appended to the signed minutes) which was introduced by Paul McKay, Director of Adults’ Services who told the Committee: -

·        The safeguarding indicators showed good improvement – information had been sought on the 10 cases that were outside the target

·        All priority 1 and 2 assessments in Deprivation of Liberty Safeguards (DoLS) cases had been completed

·        An extra £2m would be needed to complete the lower priority assessments, therefore these were being triaged to manage risk

·        Some people may have more frequent assessments than others

·        The increase in referrals over winter had caused longer timescales for assessments

·        Continued improvement was expected over the next year, but the internal indicator targets needed to be reviewed as 100% targets were unrealistic and benchmarking of other authorities was being carried out to help decide new ones

49.2   Deborah Robinson, Interim Lead Adults’ Service Improvement Programme told the Committee that the safeguarding indicators had in depth information behind them and that monthly performance management meetings now took place to help increase quality and change culture.

49.3   Summary of responses to Members’ comments and questions: -

·        The Council expected to employ an extra 21 social workers this year, thus reducing the spend on agency staff

·        Retention of staff was more difficult in the north of the county due to the attraction of higher wages in Surrey

·        Recruitment and retention of staff was a priority for the Health & Wellbeing Board which was working with district and borough councils on housing needs and also looking at pay levels

·        New equipment was to be given to social workers by November to enable them to do some administration tasks whilst away from the office – the Council was also looking at other ways to increase the amount of time social workers spent with customers

·        There was less turnover of occupational therapy staff, but the Council was still looking at how to attract newly qualified occupational therapists, including professional development opportunities

·        The social worker presence at East Surrey Hospital was to become permanent

·        The use of video, with customers’ consent, was being introduced

·        High demand, care home closures and staff sickness have cause problems

·        Community teams provided packs of local information and there was also a lot of information on the Connect to Support website re accessing support

·        Most authorities were in a similar position to West Sussex regarding DoLS assessments

·        The Council will introduce national standards for DoLS assessments

·        The order of priority was Safeguarding, DoLS, new assessments then assessment reviews

·        Customer Access Points would be set up in locations used by people

·        Early intervention should help social workers concentrate on more complex issues

·        More integration between health and social care could avoid duplication – this was another priority for the Health & Wellbeing Board

·        A map of the roll out of innovation sites would be sent to the Committee

49.4   Resolved –  ...  view the full minutes text for item 49.

Report by Executive Director Children, Adults, Families, Health and Education and Director of Adults’ Services.

The report and appendices update the Committee on the review of the Dementia Framework West Sussex 2014-19.

50.1   The Committee considered a report and presentation by the Executive Director Children, Adults, Families, Health and Education and Director of Adults’ Services (copies appended to the signed minutes) which were introduced by Irene Loft, Senior Commissioning Officer and Julie Whittingham, Mental Health/Dementia Commissioning lead for the Central Sussex and East Surrey Commissioning Alliance who told the Committee: -

·          The Framework covered the complete patient pathway and was reviewed using focus groups

·          Key successes of the Framework included raising awareness of dementia, the importance of a healthy lifestyle, the creation of a dementia zone on the Connect to Support website, an increase in diagnosis rates from 50% to 67% (the national target) and numerous referrals to the Memory Assessment Service (MAS)

·          Ways were being looked at to meet the demand for the MAS

·          Diagnosis waiting times were still too long – up to four months. There is a pilot scheme in Worthing MAS to reduce waiting times.  MAS will be renamed as the Dementia Assessment Service to ensure referrals are from people who are likely to have dementia which will help ensure people do not drop off the waiting list when they learned they were being tested for dementia

·          Dementia Action Alliances had spread across the county supporting people affected by dementia including carers and were mainly run by volunteers with time limited grants – there were also Admiral nurses in the north of the county and East Surrey hospital

·          Dementia training in hospitals had improved

·          There had been a slight increase in referrals from black, Asian and minority ethnic communities, but the figure was still low

·          Reaching people in rural areas was difficult

·          The number of people with learning difficulties being diagnosed needed to be looked at as numbers were very low – training was needed for people who provided learning difficulty services to ensure they have the right level of skills to support the person with dementia

·          Better care planning was needed for end of life care that should take place as early as possible in the person’s journey

·          The number of people with dementia was increasing by 16% per year

·          Out of 14,000 people with dementia in West Sussex, 10,000 lived in the coastal area and the number of those with a diagnosis was greater than those without

50.2   Summary of responses to Members’ comments and questions: -

·          Work was taking place to help people identify dementia before referring patients to the MAS – fast-track referrals were possible

·          Consultation on the reconfiguration of dementia wards by Sussex Partnership NHS Foundation Trust would look at travel times for carers

·          Health and social care workers were not always sharing information even when permission was given to do so

·          Health was working with proactive care teams and was encouraging the Alzheimer’s Society to do the same

·          A significant number of people were dissatisfied with training, communications and support for families – this would be addressed through the new strategy

·          A lot of information had been put on the Connect to  ...  view the full minutes text for item 50.

The report informs the Committee of the Business Planning Group meeting held on 4 February 2019, setting out the key issues discussed.

The Committee is asked to endorse the contents of the report, and particularly the Committee’s Work Programme revised to reflect the Business Planning Group’s discussions (attached at Appendix A).

51.1   The Committee considered a report by the Chairman (copy appended to the signed minutes) which was introduced by the Vice Chairman who highlighted the following: -

·        An update regarding the progress of adults in-house social care provision – ‘Choices for the Future’ was intended to go to the Business Planning Group in November

·        The NHS England (Southeast) report on the Health Needs Assessment of detainees at detention centres in West Sussex was reassuring

·        GP numbers would be discussed at the Business Planning Group meeting in June

51.2   Resolved – that the Committee endorses the contents of the report and the work programme.

Members to mention any items which they believe to be of relevance to the business of the Select Committee, and suitable for scrutiny, e.g. raised with them by constituents arising from central government initiatives etc.

If any member puts forward such an item, the Committee’s role at this meeting is just to assess, briefly, whether to refer the matter to its Business Planning Group (BPG) to consider in detail.

52.1   Resolved – that the Committee agrees to discuss the integration of Health and Social Care at a future meeting.

The next meeting of the Committee will be held on 12 June 2019 at 10.30 am at County Hall, Chichester.  Probable agenda items include:

·          Proposals to improve mental health services in West Sussex

·          Housing Related Support Update

·          Safeguarding Adults Board Annual Report

·          Improved Better Care Fund

Any member wishing to place an item on the agenda for the meeting must notify the Director of Law and Assurance by 28 May 2019.