Agenda and minutes

Leicestershire, Leicester and Rutland Joint Health Scrutiny Committee
Monday, 21 July 2008 10:30 am

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Minutes:

Apologies were received from City Councillors Dawood and Manish Sood and for County Councillors Mr Bailey, Mr Coxon and Mr Liquorish.

2.

DECLARATIONS OF INTEREST

Members are asked to declare any interests they may have in the business on the agenda and/or declare that Section 106 of the Local Government Finance Act applies to them.

Minutes:

Members were asked to declare any interests they may have in the business on the agenda and/or declare that Section 106 of the Local Government Finance Act 1992 applied to them.

  

Councillor Hall declared a non-prejudicial personal interest as he was a member of University Hospitals Leicester (UHL) and Leicestershire Partnership NHS Trusts.

 

Ms Newton CC declared that she had a non-prejudicial personal interest as she had one son employed by Leicestershire Partnership NHS Trust and a daughter employed by University Hospitals Leicester.

 

Mr Houseman CC declared a personal interest in Item 11, “Disposal of Syston Ambulance Station,” as he lived in the vicinity of Syston Ambulance station.

3.

MEMBERSHIP OF THE COMMITTEE

Members are asked to note the membership of the Leicestershire, Leicester and Rutland Joint Health Overview and Scrutiny Committee for the municipal year 2008-09 as stated on the front of the agenda.

Minutes:

RESOLVED:

                        that the Membership of the Committee be noted.

4.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 79 KB

The minutes of the meeting of the Leicestershire, Leicester and Rutland Joint Health Overview and Scrutiny Committee held on 31 March 2008 are attached and the Committee is asked to confirm them as a correct record.

Minutes:

RESOLVED:

that the minutes of the meeting on 31 March 2008 be agreed as a correct record.

5.

WORKING ARRANGEMENTS, TERMS OF REFERENCE AND WORK PROGRAMME pdf icon PDF 80 KB

Members are asked to note the working arrangements, Terms of Reference and Work Programme for the Leicestershire, Leicester and Rutland Joint Health Overview and Scrutiny Committee.

Minutes:

Kate Owen, Member Support Officer, presented the working arrangements, terms of reference and work programme.  A Member of the Committee requested an amendment to the Terms of Reference noting that LINks had now taken over from the PPIF (Patient and Public Involvement Forum).

 

RESOLVED:

                        that the report with the relevant amendment be noted.

6.

PETITIONS

The Town Clerk to report on the receipt of any petitions submitted in accordance with the Council’s procedures.

Minutes:

No petitions were received.

7.

QUESTIONS, REPRESENTATIONS, STATEMENTS OF CASE

The following question has been received:

 

From Alan Stanley – Keep our NHS Public Leicester, Leicestershire and Rutland

 

I am writing to you on behalf of keep our NHS Public Leicester, Leicestershire and Rutland to ask you to investigate the Birkdale contract which provides for orthopaedic operations to be carried out in UHL.  This contract, we understand after only four weeks following what appeared to be significant errors on the part of the Birkdale surgeons.

 

We are concerned that this contract was drawn up despite a previous history on the part of Birkdale of poor quality and complaints.  We would like the Health Overview and Scrutiny Committee to investigate:

How the contract came to be drawn up

What alternative approaches to meeting the 18 week treatment target were explored what would keep health care publicity provided and why these were rejected

Why Birkdale was selected when information about previous poor quality was already in the public domain

What the terms of the contract are

Why more information about the contract has not been made public

What quality procedures were in place within Birkdale and within UHL’s monitoring of Birkdale

What Birkdale will be paid despite these apparent errors

What the standing of Birkdale’s surgeons is

What the standards of post-operative care were

What the financial loss to the local health community has been.

 

We believe that an investigation of this matter would be entirely appropriate under s244 of the National Health Service Act 2006 and the Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulation 2002 (Statutory Instrument 2002 No. 3048)’

Minutes:

Birkdale

 

Janet Rowe was present on behalf of Alan Stanley, Keep our NHS Public Leicester, Leicestershire and Rutland, and read out the question as outlined on the report.  Malcolm Lowe-Lauri, the Chief Executive of the University Hospitals of Leicester NHS Trust (UHL) responded to the question as detailed below:

 

 

1.

UHL entered into a contract with the Birkdale Clinic in January 2008 to assist the Trust in meeting its 18 week waiting list targets in relation to the following services:-

 

  • Orthopaedics,
  • Plastic surgery,
  • Maxillofacial.

 

 

 

 

2.

The arrangement was for NHS Consultants from other parts of the country, who were contracted to the Birkdale Clinic, to carry out operations in UHL operating theatres at weekends to help reduce waiting times for patients.

 

3.

UHL made it a condition of the contract that the Consultants were NHS Consultants and registered on the General Medical Council Specialist Register.

 

4.

The decision to enter into the contract was taken by UHL Trust Board in December 2007.  The Trust’s Solicitors prepared the contract documentation under which Birkdale was obliged to provide healthcare to best standards and to comply with the Trust’s policies and procedures.

 

5.

The Trust’s own Consultants were already committed to working at full capacity in these specialties, and it was therefore necessary for the Trust to access additional capacity and capability to help reduce patient waiting times and meet national waiting time targets by 31 March 2008.

 

6.

The Birkdale Clinic was known to the Trust as an experienced provider of clinical services to the NHS.  In 2003, Birkdale had been appointed by the Department of Health to run an Independent Sector Treatment Centre to treat NHS patients.

 

7.

Prior to entering into the contract, the Trust carried out due diligence and reviewed reports published by the Healthcare Commission assessing Birkdale’s own hospital facilities in Rotherham.  UHL governance procedures were put in place to make sure that, on important issues like infection prevention and control, the clinicians worked to the Trust’s exacting standards.  The Trust also spot checked wards for reassurance that UHL quality processes were being met in practice.

 

8.

Eight weeks into the arrangement, in March 2008, UHL Consultants raised a number of clinical concerns regarding some orthopaedic cases.  No difficulties were encountered with Birkdale’s maxillofacial work, and, in the event, no plastic surgery work had then been undertaken by Birkdale.

 

9.

As a result of these concerns, the Trust decided to suspend the arrangement with Birkdale and has since conducted a review of the 210 patients who had received orthopaedic treatment. 

 

10.

The Trust informed the Healthcare Commission of its actions in suspending the contract and has since made information available to the Healthcare Commission at its request.

 

11.

Whenever surgery is undertaken, complications are expected in a proportion of cases.  In other words, all surgery carries an element of risk.  However, thankfully our review has not established any significant overall pattern of poor outcomes in those patients treated by the Birkdale Clinic.

 

12.

The period of the original  ...  view the full minutes text for item 7.

8.

NEXT STAGE REVIEW pdf icon PDF 151 KB

Tim Rideout, Leicestershire Lead for the Next Stage Review, will introduce the ‘Excellence for All’ vision for Leicestershire, Leicester and Rutland. (This is being launched on 15 July 2008 and further papers will be circulated to Member on that date and copies will be available at the meeting).

 

Malcolm Lowe-Lauri, Chief Executive of University Hospitals of Leicester NHS Trust, will outline the contribution of the acute sector to the Next Stage Review.

Minutes:

The Committee heard a presentation introducing the ‘Excellence for All’ vision for Leicestershire, Leicester and Rutland, and the Next Stage Review. Presenting the information was Jo Yeaman, Next Stage Review Lead – Engagement and Consultation, Malcolm Lowe-Lauri the new Chief Executive of the University Hospitals of Leicester NHS Trust, and Helen Seth, Deputy Director of Operations (Modernisation). Apologies were given for Tim Rideout who was unable to make the meeting. 

 

Jo Yeaman stated that  reviews were being carried out across the country as part of the national ‘Our NHS, Our Future: Next Stage Review’, which was being led by Lord Darzi. In Leicester, Leicestershire and Rutland (LLR) NHS organisations had been working jointly on their review called ‘Excellence for All’.  A number of documents had been published to provide information and allow feedback, these were available in leaflet and more detailed forms.

 

The focus of the LLR review was on improving the health and well-being of people living locally, and based on seven key principles which were outlined in the report.  The vision explained how health services might be delivered in the future which, if undertaken, would change the way the service was provided.  The formal engagement had commenced on 15 July 2008 and would conclude on 5 October 2008.

 

A Member of the Committee enquired about which committees addressed children’s mental health.  In response Jo noted that this was split between the Children’s and the Mental Health workstreams. A Member of the Committee asked if these nursing services would be based in schools.  Jo acknowledged that the number of school nurses was currently below an adequate level. Funding had been allocated for 8 school nurses and recruitment was underway.

 

In response to a question regarding emergency care Jo explained that more services needed to directed locally and away from unnecessary hospital treatment.  Helen Seth explained that in addition to this better access would be needed, such as public transport.

 

A Member of the Committee expressed concern that existing dialysis service users of the Health service had not been consulted.  It was agreed that work needed to be carried out to include this group.

 

A Member stated that in 2007/08 the NHS organisation within LLR collectively made a surplus and was expected to do so again in 2008/09.  Malcolm Lowe-Lauri reported that the UHL had a current credit  balance of £500,000.  Concern was expressed that the surplus might have come from gaps in the services, as there were many areas  that needed the money, such as building improvements.  Malcolm noted that these areas were covered separately. UHL was investigating how it could access the national capital money previously identified by the Department of Health to begin to address estate concerns within UHL.

 

Helen Seth explained how the Next Stage Review would fit with the University Hospitals Leicester (UHL) emerging strategy, which would better serve the needs of the patients requiring acute hospital care. Helen reported that there would be work carried out with patients to enable them to access more  ...  view the full minutes text for item 8.

9.

NO. 1 THE GRANGE pdf icon PDF 83 KB

The Leicester Partnership Trust submits a paper that provides an update on the report provided to the Committee on 17 March 2008 regarding the future provision of short break services for people with learning disabilities, which are currently provided at No. 1 The Grange. 

Minutes:

Professor Anthony Sheehan, Chief Executive, Leicester Partnership NHS Trust, Liz Howes, Acting Director of Learning Disability & Specialist Mental Health Services, Christine Palmer Associate Director of Communications, and Tony Burnell, Director of People and Business Effectiveness were present at the meeting.  Anthony Sheehan presented the Leicestershire Partnership Trust’s report on Services Provided at Number 1 The Grange.

 

At the meeting on 17 March 2008 the Committee were informed that the closure of The Grange was to be postponed until 30 September 2008.  This extended time had allowed the service to have further communication with the users of this service and carry out an internal review. 

 

The Trust had reviewed the options with the Executive Short Breaks Group and decided that The Grange would remain open at least until 31 March 2009 and financial support would be shared across the Partners.  A final decision on the Grange would depend on the outcome of the Health Short Breaks Review.  Anthony Sheehan expressed his thanks to the Partners involved.

 

A Member of the Committee queried if there had been a drop in the use of the service.  In response Liz Howes noted that there had been no change as the service was operating as normal and new clients had been accepted.  If there were changes to be made users would be given notice.

 

A Member of the Committee suggested that a copy of the equalities impact assessment and the final strategy for The Grange be made available to the Committee when available. 

 

Bhupen Dave, Service Director, Community Care Services, stated that in his view this was a positive report. report and that the funding currently being used to keep The Grange open was from all  partner agencies involved, including the Local Authorities. The Short Break Strategy was offered to the Committee when completed.

 

RESOLVED:

1.     that the outcome of the Health Short Breaks Review be submitted to the committee.

 

2.     that a copy of the equalities impact assessment be provided to the Committee.

10.

PERSONAL DEVELOPMENT PLANS- PROGRESS ON ACTION PLAN AND ANY IMPACT ON STAFF RETENTION pdf icon PDF 56 KB

The Leicester Partnership NHS Trust (LPT) submits a report that provides an update on the Health Standard C8b, which was declared non-compliant at the end of 2007-08.

Minutes:

Professor Anthony Sheehan, Chief Executive, Leicester Partnership NHS Trust, Liz Howes Acting Director of Learning Disability & Specialist, Christine Palmer Associate Director of Communications, and Tony Burnell Director of People and Busniess Effectiveness were present at the meeting.  Tony Burnell presented a report on the Leicestershire Partnership NHS Trust’s personal development plans (PDP).  Following the declaration of non-compliance against Healthcare Standard C8b the Trust had developed an action plan with supporting systems to ensure that all staff would have a current PDP in place by October 2008.  It was reported that it had not been felt by staff in their exit interviews that the absence of PDPs was a factor in their decision to leave.  The staff turnover was lower than the public sector average and there were no difficulties in recruitment.

 

A Member of the Committee queried if there had been any changes following the staff surveys and low rate of appraisals.  Tony noted that for the staff that were in work there would be 100% rate of appraisals carried out. This was for all staff in work at any one time as staff on secondment, maternity leave etc could not receive their PDP.  Anthony Sheehan reported that at that level they would be above the rate of any other Trust in the country.

 

The number of staff in post had fallen since 2003; Members asked if there  had been a staff retention problem.  In response it was reported that this was more likely from changes in services and a number of cost improvements.

 

Members requested that when the Trust submitted their declaration for 2008/2009 it would provide the percentage of people who had received the PDPs.  It was felt that the PDPs provided staff with an opportunity to present concerns, and thus make them feel more valued.

 

The Chair expressed the Committee’s thanks for the report.

 

RESOLVED:

that when the Trust submitted their declaration for 2008/2009 that it would provide an outline of the developments in the Personal Development Plans. 

11.

DISPOSAL OF SYSTON AMBULANCE STATION

Ian Donnelly, East Midlands Ambulance Service will give a presentation.

Minutes:

Glenn McTeak, East Midlands Ambulance Service, reported on the disposal of the Syston Ambulance Station.  He gave apologies for Ian Donnelly who was unable to attend the meeting.  He reported that consultation had taken place with staff at the station.  The closure would have an impact on the staff, and for this reason there was no intention to rush the process.  It was envisaged that the process would take around six to twelve months.

 

A Member of the Committee queried if a blue light service was still run from the station.  In response Glenn explained that this was traditionally a standby station.  The new standby point was in discussion to see how this could best serve the community.  Members expressed concern that there were not any alternative facilities yet in place for staff.

 

Members  queried what was happening with the sale of the ambulance station.  Glenn understood that the process was still underway and it had not been removed from the market.

 

Glenn assured the Committee that any decisions regarding the service were not influenced by financial problems caused by the rising fuel prices.  Funding had been allocated  to the Leicestershire services for that purpose and they were achieving their targets.

 

RESOLVED:

                        that the report be noted.

12.

DATES OF FUTURE MEETINGS

Members are asked to agree dates for future meetings of the Committee for as suggested below:

 

Monday 22 September 2008

Monday 24 November 2008

 

All meetings to start at 10.30a.m.

Minutes:

RESOLVED:

that 22 September 2008 and 24 November 2008 be agreed as future meetings.

13.

CLOSE OF MEETING

Minutes:

The meeting closed at 1.16pm.