Agenda and draft minutes

There were no declarations of interest made at the meeting.

There were no questions from members of the public present at the meeting

Minutes of the meeting held on the 8^th December are attached.

With regards to Minute number HSC.355, the Principal Democratic Service Officer reported that she had liaised with a representative from NHS England in respect of the proposed cuts to Community Pharmacy Budgets.  The representative reported that the Department of Health had announced cuts to the budget however it will be up to individual pharmacies to ascertain if it is commercially viable to continue to operate. 

In respect of Minute number HSC.356 Annual Adult’s Social Care Complaints Report, the Principal Democratic Services Officer reported that the Customer Engagement Officer reported that the department were unable to provide data in respect of the age range of the complainants as a comparison to the age range of the service user.

It was agreed:

That the minutes of the meeting held on 20th October 2016 be approved as a correct record.

Dr K Patel and representatives from Bury Clinical Commissioning Group will report at the meeting.  Reports will be sent to follow.

Members of the Committee considered a verbal presentation from Stefan Verstraelen, Inspection Manager, CQC.  The verbal presentation contained the following information:

The purpose of the CQC is to make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.  The role is to monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care.

The CQC ask five key questions of all services:

Is it safe?

Is it effective?

Is it caring?

Is it responsive?

Is it well lead?

There are three phases to the inspection process; Pre-inspection, which includes provider information returns, intelligence monitoring and recruitment of the inspection team.  The Inspection; which will include core services, five key questions, key lines of inquiry and visits to clinical areas as well as focus groups and interviews.  Thirdly, post inspection, which includes the report, the regulatory (enforcement arm) and rating.

There is a four point scale for rating  core services and providers: Outstanding, Good, requires Improvement and Inadequate.  The CQC will consider taking enforcement action if providers are not meeting the regulations, for example:  issuing requirement notices or warning notices, imposing conditions, placing a provider in special measures,issuing simple cautions and/or fines and prosecuting cases where people are harmed or placed in danger of harm.

Those present were given the opportunity to ask questions and make comments and the following points were raised:

In response to a Member’s question, the Inspection Manager reported that the CQC can, were deemed appropriate to do so, carry out a focused inspection visit, concentrating on one area or core service.  In deciding to do a focused visit the CQC would weigh up, the concerns raised, the purpose of the visit and the impact or consequences of any such visit.  The Inspection Manager reported that the CQC can, if required, be in attendance within hours of concerns being raised.

With regards to the key question, is an organisation caring?  The Inspection Manager reported that the CQC would gather evidence via a variety of methods, such as; using intelligence from the Family and Friends test, feedback from focus groups, speaking with patients and their relatives/carers, as well as observing how the staff interact with patients while conducting the inspection visits.

In response to concerns raised with regards to the CQC identifying any themes or trends, the Inspection Manager reported that the biggest theme at the current time is a seemingly national shortage of staff/recruitment problems. 

If a provider is found to have breached a regulation, the CQC will raise their concerns with the provider immediately and ask them to confirm how they plan to address the issues raised.  The CQC works with providers and partnership organisations, such as NHS Improvement, to resolve any statutory breaches and encourage improvement.

In response to a Member’s question with regards to timescales, the Inspection Manager reported that  ...  view the full minutes text for item HSC.379

Dr K. Patel, Chair Bury CCG, attended the meeting to provide members of the Board with an update on the provision of physiotherapy services across the Borough following a review and changes to the service in 2015. 

Dr Patel reported that the musculoskeletal physiotherapy team provide a service to prevent, treat and manage a wide range of musculoskeletal conditions.  Referrals are received electronically by a dedicated physiotherapy administration team based at Fairfield General Hospital. 

The standard waiting time for urgent referrals is within 7 days and routine referrals within 6 weeks.  The do not attend rate is10%.

The service is provided in community locations as well as Fairfield General and North Manchester General Hospitals.  The service is provided in the following community settings:

·         Radcliffe Primary Care Centre – 16 sessions per week

·         Townside Primary Care Centre – 10 sessions per week

·         Elms medical Centre – 1 session per week

·         United Reform Church, Parsons Lane – 1 session per week

·         Our Lady of Grace Fairfax Road, Prestwich – 1 session per week

A physiotherapy patient experience survey has recently been conducted which shows levels of satisfaction with the service, to be in excess of 95%.

Those present were given the opportunity to ask questions and make comments and the following points were raised:

In response to a Member’s question, the CCG Chair, reported that the patient satisfaction survey was unable to identify previous patients/the old cohort within the survey.

The number of urgent referrals is very small as a percentage of the overall number of referrals. 

The CCG Chair reported that the service model is slightly different in Radcliffe, the service puts greater emphasis on self care.

In response to a Member’s question, the CCG Chair reported that there has been difficulties in identifying sites for Clinics in Ramsbottom and Tottington.

It was agreed:

Dr K Patel be thanked for his attendance.

                          Mike Owen, Chief Executive, Bury Council and Stuart North, Chief Operating Officer Bury CCG attended the meeting to provide members with a verbal presentation in respect of the Locality plan, the OCO and the LCO.  The presentation contained the following information:

The proposed changes will result in a new relationship between public services and citizens, communities and businesses that enables shared decision making, democratic accountability and voice, genuine co-production and joint delivery of services. He stressed that they involve treating communities as assets and doing with them, not to them.  Individuals will have greater responsibility, ownership and control of their own health and wellbeing including their environment within the community.  The proposals are seen as the right thing to do and are not driven by the need to make cost savings although they should lead to a reduction in the number of avoidable contacts and demand for specialist, higher cost, services.

The One Commissioning Organisation will bring together the commissioning functions of Council and CCG.  The CCG will transfer into the Councils structure on 1 April 2017 and operate as a virtual commissioning organisation with integrated meeting structures and decision making.

Functions of the OCO:

?      Oversee flow of resources in and out of Borough

?      Define standards and outcomes

?      System leadership and leaders for transformation

?      Local assurance body

?      Shapes the market

A Programme Initiation Document approved by Joint Leadership Team, programme structure being established and work being undertaken to scope quick wins

The Locality Care Organisation will bring together five key provider partners and GP representatives from the 4 Sectors and will operate as an Alliance from April 2017.  With two high level outcomes:

?      Well-being (long term)

?      Urgent care – stabilising the system

As well as an all age, out of hospital model, focused around Neighbourhoods and the establishment of a Programme Board.

Those present were given the opportunity to ask questions and make comments and the following points were raised:

The Chief Executive reported that the CCG will continue to exist as a legal entity, these plans are concerned with the allocation of resources for health and social care and ensuring that this is undertaken jointly, taking into account, clinical, political and managerial input.

The Chief Operating Officer, Bury CCG reported that the Locality Care Organisation will be the delivery arm of the proposed changes; urgent care provision is severely under strain and it is imperative that these proposals will help to stabilise the health and social care economy.  The organisation will operate via quasi-contractual arrangements, some budgets will be brought together others will be legally pooled.

The Chief Executive reported that these proposals will be about a whole system approach to the issues affecting the health and social care economy in the Borough.  The Chief Operating Officer reported that working together will help to improve outcomes and maximise opportunities.

The Chief Operating Officer reported co-commissioning services across health and social care that this is a genuine attempt to work collaboratively with partners, key stakeholders and the third  ...  view the full minutes text for item HSC.381

There was no urgent business reported at the meeting.There was no urgent business reported at the meeting.

Members considered an updated work programme.