Agenda and minutes

Health Scrutiny Committee
Tuesday, 5th March, 2019 7.00 pm

Venue: Meeting Rooms A&B, Bury Town Hall

Items
No. Item

HSC.381

DECLARATIONS OF INTEREST

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.

Minutes:

There were no declarations of interest made at the meeting.

HSC.382

PUBLIC QUESTION TIME

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

Minutes:

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

 

HSC.383

MINUTES pdf icon PDF 58 KB

Minutes from the meeting held on 23rd January 2019 are attached.

Minutes:

It was agreed:

 

That the minutes of the meeting held on 23rd January 2019 be approved as a correct record.

 

HSC.384

GP - EXTENDED WORKING HOURS SERVICE pdf icon PDF 381 KB

Martin Clayton, Chief Officer, GP Federation and Marie Clayton, Deputy Director of Primary Care, Bury CCG will report at the meeting.  Presentation attached.

 

Minutes:

Martin Clayton, Chief Officer GP Federation Marie Clayton, Deputy Director of Primary Care Bury CCG attended the meeting to provide members with an update on the GP extended working hours service (EWH).

 

The GP Federation Chief Officer provided an overview of the EWH service:

      The service is provided across 3 site:

     Radcliffe Primary Care Centre

     Moorgate Primary Care Centre

     Prestwich Health Centre

      Hours of services are:

     6:30pm – 8.00pm weekdays

     8.00am – 6.00pm on weekend and bank holidays

      Services include availability of GPs and Primary Care Nurses

      The service provides approximately 360 appointments per week

 

Additional services are provided by nursing staff, services provided have included, COPD and asthma reviews, ECGs and diabetic reviews. Appointments are split with 78% of patients seen by a GP and 22% by a nurse.

 

The Deputy Director of Primary Care reported that during 2019/20 a national review of the Urgent Primary Care offer is being undertake – this will include: Out of Hours, Extended Working House and Urgent Care Treatment Centre.

 

The Chief Officer reported that digital availability to General Practice is a key development area of the next two years with:

     Extended online booking

     Access to the full patient record online with patient write available

     Ordering repeat prescriptions online everywhere

     Online consultation

 

Those present were invited to ask questions and the following issues were raised.

 

Responding to a Member’s question the GP Federation’s Chief Officer reported that the Federation is a limited company owned by the GPs in Bury, they are commissioned by the CCG to deliver the extended hours service. 

 

In response to a Member’s question, it is hoped that the development and expansion of the digital offer will take place in the next 18 months.  The Chief Officer confirmed that GPs working within the extended hour’s service have access to the patient’s full medical record.   

       

Members discussed problems with accessing GP appointments and a lack of consistency across the Borough.  The Deputy Director of Primary Care reported that within the next 12 months it is hoped that all GP surgeries will have an online patient facility.  Each practice is different and the CCG is working with GP surgeries to increase access and improve consistency across the Borough.

 

Responding to a Member’s question the Chief Officer reported that the extended hours service was not established to deflect activity away from A&E but to increase the numbers of available GP appointments.  However evaluation undertaken by the GP Federation concluded that following the first two years of operation there was a 4% deflection rate from A&E. 

 

The Chief Officer reported that feedback from patients is undertaken and recent feedback reported a 88% positivity rating for the service which is similar to that reported in GP surgeries.

 

It was agreed:

 

The Chief Officer of the GP Federation and the Deputy Director of Primary Care Bury CCG be invited to attend a future meeting to update on the proposed contract changes  ...  view the full minutes text for item HSC.384

HSC.385

PERSONA CARE AND SUPPORT UPDATE pdf icon PDF 157 KB

Kat Sowden Managing Director Chair, Stewart McCombe.

Persona Care and Support will report at the meeting.  Report attached.

 

Additional documents:

Minutes:

Kat Sowden, Managing Director Persona Care and Support and Stewart McCombe, Chair, Persona Care and Support attended the meeting to provide members with an update on Persona Care.  The presentation contained the following information:

 

Persona operates independently but is wholly owned by Bury Council and provides a range of adult social care services to people who are vulnerable due to age or disability.

  • Day Services supporting 390 customers per week
  • Short Stay Services supporting 223 customers
  • Supported Living Services supporting 139 customers

 

The workforce has grown from 350 in October 2015 to 450 in December 2018. This growth is linked to increasing resilience in flexible staffing as well as business growth. The workforce make up is 70% Local Authority terms and conditions, 29% Persona terms and conditions and 1% other (due to the TUPE in of a small service from another employer).

 

There have been some challenges in maintaining a Good CQC rating across all services. The main area of concern has been Spurr House.  A re-inspection is imminent.

Those present were invited to ask questions and the following issues were raised.

 

Members discussed the high levels of reported sickness across the organisation.  The Managing Director reported that the majority of sickness is musko-skeltal however cases of long term sickness rates have gradually increased.  Incentives have been introduced within the organisation to address the sickness levels, the Managing Director acknowledged this is an ongoing issue for the organisation.

 

With regards to the CQC rating at Spurr House, the Managing Director reported that she was very disappointed with the requires improvement rating in 2017.  An immediate plan was put in place to address some of the problems, the issues identified weren’t significant but were as a result of “silly and sloppy errors”.  Audits are conducted intermittently; the management team at Elmhurst are now supporting and responsible for Spurr House and a subsequent inspection is imminent.

 

Responding to a question from the Chair, the Managing Director reported that they do collate complaints information and this can be provided to the Committee.  The majority of which concern short stay placements and can sometimes be triggered by someone receiving their bill.  A compliance manager role has been created to deal with complaints and identify any trends across the organisation.

 

The Managing Director reported that they are a local authority trading company and as such 80% of the business is transacted with the Council.  They can generate the remaining 20% via self-funding and direct payment clients, this is an area where there could be significant growth.

 

In response to a Member’s question, the Managing Director reported that Persona works in partnership with the Council.  This partnership work has resulted in a decision to give a £200,000 dividend back to the Council in 2019/2020.

 

Members discussed the lack of Councillor Representation on the Persona Board.  The Managing Director reported that there was a good relationship with the Council and governance is strong within the organisation.

 

Responding to a question as to why Persona does not  ...  view the full minutes text for item HSC.385

HSC.386

URGENT BUSINESS - Mutually Binding Agreement pdf icon PDF 90 KB

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

Additional documents:

Minutes:

Kath Wynne Jones, LCO Chief Officer attended the meeting to provide members with an update in respect of the development of the LCO’s Mutually Binding Agreement (MBA).  The MBA is a collaboration agreement for the establishment and operation of the Local Care Organisation, as a formal alliance of organisations which have agreed to work together in a single delivery and accountability structure.  The new agreement marks a further stage in the development of a Local Care Organisation (LCO) to become a free standing and separate legal entity with a target date of the year 2020/21. Until then it will remain a contractual alliance between the participating bodies including the Council.

The six partners are; BARDOC, GP Federation, Council, Bury VCFA, Northern Care Alliance and Pennine Care; talks are ongoing with a potential seventh partner, Persona.

 

The MBA will drive development and improvements to the way health and care services are commissioned and delivered in Bury.

 

The Northern Care Alliance NHS Group will be the host body for the year 2019/20. The status of the staff employed by the participating bodies remains unchanged as does existing contracts. Certain functions are therefore delegated to the LCO and a number of matters are reserved to the respective participating bodies, including the Council.

 

 

The LCO Chief Officer outlined the key areas to note within the 2019 MBA:

a)   Explicit statements of what services are in scope and under the operational management of the LCO

b)   Clarity on the governance and accountability arrangements to support operational management, underpinned by a workforce protocol

c)   Clarity on the investment agreement between the Bury Local Care Organisation

d)   Explicit statements of delegations and reserved powers from each of the partner organisations

e)   Principles of risk and reward share

 

Those present were invited to ask questions and the following issues were raised.

 

Responding to a Member’s question, the Chief Officer reported that the LCO’s governance arrangements are still being developed and this would include a review of Board members including Council representation.  In terms of the amounts of money that will be delegated to this new organisation initially it is envisaged there will be £8 million from Adult Social Care, £17 million community services and a further £120 million from other services.

 

Transformation monies from Greater Manchester will be utilised in the establishment of the LCO and the OCO.  It is envisaged that these organisations will transform and align the Council and CCG commissioning functions.

 

The Chief Officer reported that she does not anticipate the proposed changes will result in a reduced workforce.  The transformation changes which include the development of integrated neighbourhood teams and intermediate tiers of support will allow for greater staff progression and development. Staff will be provided with opportunities to work in partner organisations.

 

With regards to concerns about creating another layer of bureaucracy, the LCO Chief Officer reported that the creation of the LCO will hopefully minimise bureaucracy by aligning single line management structures, process and ultimately IT systems.

 

It was agreed:

 

The LCO  ...  view the full minutes text for item HSC.386