Agenda and draft minutes

Health Scrutiny Committee
Tuesday, 11th October, 2016 7.00 pm

Venue: Meeting Rooms A&B, Bury Town Hall, BL9 0SW

Contact: Julie Gallagher 

No. Item



Members of Health Scrutiny Committee are asked to consider whether they have an interest in any of the matters on the agenda and if so, to formally declare that interest.


There were no declarations of interest made at the meeting.




Questions are invited from members of the public present at the meeting on any matters for which this Committee is responsible.


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



Sir David Dalton, Interim Chief Executive Pennine Acute NHS Trust will report at the meeting.  CQC Report and presentation attached.

Additional documents:



Professor Matt Makin, Executive Medical Director, Pennine Acute NHS Trust attended the meeting to provide members of the Committee with an update in respect of the Care Quality Commission inspection report and subsequent action plan.  A copy of the CQC inspection report had been circulated to Members prior to the meeting.  The presentation contained the following information:


Following a comprehensive inspection, the CQC rated Pennine Acute Hospitals NHS Trust inadequate in both safety and well-led domains. In line with CQC policy the inspection team considered recommending the trust go into special measures, such is the level of concern identified around quality and safety.  Immediately following the CQC inspection, Salford Royal NHS Foundation Trust was asked to assume leadership of the Trust. Salford’s leadership team, rated outstanding by the CQC put in place a comprehensive plan for further investigation into the challenges faced by Pennine Acute.


The Salford Royal Diagnostic, identified additional critical risks to patient care & safety; unsafe/unreliable staffing, variation in care delivery and outcomes for patients; governance systems that are broken or do not exist; Board that is disconnected; Poor leadership; Cultures that normalised sub standard care; Staff that are disengaged and poor external relationships and unreliable service design and structures.


A summary action plan has been developed with six key themes.  Four services have been identified as “fragile”; maternity services, urgent care, paediatrics and critical care.  An Improvement Board has been established, under the Chairmanship of Jon Rouse, Chief Officer, Greater Manchester Health and Social Care Partnership.


The Executive Medical Director reported that systems in place at Salford Royal would be implemented at Pennine Acute NHS Trust, these include systems in respect of, Risk Management and Assurance, Nursing Assessment and Accreditation; Open and Transparent Reporting, Visible Leadership and Quality Improvement Methodology.


The Executive Medical Director reported that part of the action plan is the proposed break-up of the centralised management within the Trust. The creation of a new site placed leadership with the appointment of nurse directors, medical directors and managing directors at each site; as well as a clear accountability framework to deliver on improvement plans and strengthen locality relationships and planning.


Since the inspection report 104 new registered nurses and midwives have been recruited, 14 doctors (consultant and middle grades) as well as 69 health care support workers.


The Chief Operating Officer reported that two main themes have emerged from the CQC, staff shortages and poor leadership.  The CCG have confidence in the new leadership to address the issues and concerns highlighted in the CQC report.


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


In response to Member’s concerns in respect of the new management arrangements, the Executive Medical Director reported that the proposed site management system would allow for greater autonomy on a site by site basis.  Discussions are still ongoing as to where the overall responsibility will sit in respect of the Trust Board.


With regards to staff feeling unable to raise concerns,  ...  view the full minutes text for item HSC.318



Sir David Dalton will report at the meeting.


Professor Makin, Executive Medical Director Pennine Acute NHS Trust, attended the meeting to provide members of the committee with an update in respect of the proposals for a City of Manchester Single Hospital Service. 

Manchester City Council Health and Wellbeing Board (MCCHWB) had appointed Sir Jonathon Michael as an Independent Review Director with a commission to produce a report on the proposed SHS. The review was set out in two phases:-

Phase 1 – Benefits Assessment (completed April 2016)

Phase 2 – Governance and Organisational Arrangements (recommendations submitted to the Manchester City Council Health and Wellbeing Board on 8 June 2016. A copy of the report had been circulated.)


The review has recommended the creation of a new NHS Trust to encompass the three hospitals in Manchester (UHSM, CMFT and PAT). This would deliver a Local Care Organisation and enable a single commissioning function that would also support the Manchester Locality Plan. The MCCHWB agreed to request CMFT, UHSM and PAT to enter into discussions to consider the creation of a new single organisation and to provide an initial assessment on implementation requirements and timescale.


The outcome of the discussions would be reported back to the MCCHWB within 6 weeks. In addition, the review also highlighted that further discussions were required on the strategic alignment between the Manchester Single Hospital Service review and the North East sector review. This would include minimising any adverse impact from the realignment of North Manchester General Hospital on the sustainability of either the remaining clinical services provided by Pennine Acute Trust or the proposed new City wide Hospital Trust.


Members of the Committee discussed the implications for the three remaining hospital sites as well as issues with patient pathways and patient flows into NMGH.  Members expressed their concern that uncertainty around the future of the Trust would not help alleviate the problems identified within the CQC report.


The Executive Medical Director reported in order to assist with some of the problems associated with recruitment and retention within the Trust, it would be helpful if a decision is taken sooner rather than later in respect of the City of Manchester Single Hospital Service.


It was agreed:


The Health Overview and Scrutiny Committee would receive regular updates in respect of the City Of Manchester Single Hospital Service.




Stuart North, Chief Operating Officer, Bury Clinical Commissioning Group, will report at the meeting.  Presentation attached.


Stuart North, Chief Operating Officer Bury CCG, gave a verbal update on the current engagement with the public to support the configuration of Urgent Care Services in Bury. A review of current service provision had concluded that the system was disjointed, had areas of inequality and supported duplication of some services in Bury.  It was reported that the new model of service provision would not be about saving money but was about public engagement, ensuring that investment in services was being made in the right areas in order to provide a more simpler and efficient service. 




The Chief Operating Officer reported that the result of the engagement exercise will form part of the report that will be considered by the CCG Board in December 2016.


The Programme Manager reported that a series of engagement exercised had been undertaken by the CCG including presentations at all six Township forums.


The Chief Operating Officer reported that the purpose of the review is to ensure that the right care and the right treatment is provided in the right place.  There will be six clinical hubs all providing a range of services providing equality of service provision across the Borough.


In response to a Member’s question the Programme Manager reported that the proposals would looked to include a Primary Care front end service at Fairfield General Hospital.  This service would provide a primary care presence and would allow GPs to triage patients.


The Programme Manager acknowledged that there had been initial teething problems with the NHS111 service, it is envisaged that the service would be developed to provide a localised Bury response. 


In response to a Member’s question the Chief Operating Officer reported that of the 67,000 patients seen in the walk in centres in 2015/16 could have been seen in a suitable alternate provision. 


With regards to communication and engagement the Chief Operating Officer reported that the CCG would need to ensure all the information in respect of services provided is kept up to date and easily accessible to members of the public.  The Chief Operating Officer reported that he would be very reluctant to double run services, as evidence suggests that the more services made available to the public the more patients will use them. 


The Chief Officer reported that these proposals were not about saving money.  The proposals would ensure that patients access the services via the most appropriate patient pathway.  A front-end primary care service at Fairfield Hospital will help to alleviate some of the pressures on A&E centres as well as being able to treat patients that would have previously attended a walk in centre.


The Chief Officer reported that the proposals will involve re-educating patients in where to get the best most appropriate treatment, provide information and advice with regards how to self care and encourage patients to use their local pharmacist.


It was agreed that:


Once the outcome of the engagement exercise in respect of the Urgent Care Redesign has been considered by the Board of  ...  view the full minutes text for item HSC.320



Any other business which by reason of special circumstances the Chair agrees may be considered as a matter of urgency.


There was no urgent business reported at the meeting.