Agenda and minutes

Councillor A Simpson declared a personal interest in respect of all items to be considered due to her appointment as Lord Peter Smith’s assistant at the Greater Manchester Health and Social Care Partnership Board.  Councillor Simpson is also employed by the NHS.

Minutes of the meeting held on 27^th November 2018 are attached.

Councillor Simpson informed the meeting that following of from the discussion at the last meeting in respect of loneliness, as subsequent meeting of the task and finish loneliness group has taken place and an event has been arranged for Sunday 17^th March, members of the Board are encourage to attend.

The Director of Public Health will share with Councillor Walker the GM consultation document in respect of substance misuse services.

It was agreed:

The minutes of the meeting held on the 27^th November 2019 be approved as a correct record.

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

Further to the published agenda the Chair agreed that the agenda would be re-arranged and the Safeguarding Adults and Children’s Annual Report would be considered first.

Maxine Lomax, representing Bury CCG will report at the meeting.  Reports attached.

Maxine Lomax Head of Safeguarding/ Deputy Director of Nursing and Dr Cathy Fines attended the meeting to present the Children Looked After, CQC Safeguarding Report.  The report is intended to brief the committee on the process and outcome of the recent inspection by CQC into the quality of provision and the implementation of the provision for children in need of protection and children who are looked after

The outcome of the inspection was a published 42 page report and 46 recommendations for commissioners and providers across the health economy of

Bury.

The key concerns that emerged were from the visits to Fairfield General A&E department and to the two Walk in Centre’s. There was an immediate request by the CQC, for an action plan to remediate the concerns identified at A&E. This was submitted, as requested by the end of the inspection. PAT have initiated an improvement board to monitor the action plan.  Additionally, there were concerns around the sustainability of the Walk in Centre’s, staff moral and systems and processes to safeguarding children. Pennine Care was made aware of the concerns immediately and the Head of Safeguarding for the CCG was informed. Pennine Care have provided some assurances around the WIC’s however, there are a number of recommendations within the report.

Questions were invited from those present and the following issues were raised:

Councillor Briggs raised a number of concerns with regards to the CQC report, in particular, poor leadership, IT problems, the use of fax machines for referrals and staff shortages, as well as delays in referring patients.  Responding to these concerns the Head of Safeguarding reported that faxed referrals were only used in two premises (A&E and the walk in centres) this practice has now stopped.  Seven inspectors, visited 14 services over a week long period, there is not the capacity in the system to provide that level of scrutiny and assurance. 

Responding to a Member’s question, the Head of Safeguarding reported that training is provided regularly, in some service areas where there is a high turnover of staff, ensuring that all staff have had up to date training remains a challenge.

Responding to concerns raised by the Chair with regards to whether there is sufficient workforce capacity to deliver on the CQC recommendations, the Head of Safeguarding reported that following on from the Ofsted inspection additional capacity has been provided by Pennine Acute NHS Trust.  The Pennine Care NHS Foundation Trust and the Local Authority has provided some additional funding for the Multi-agency Safeguarding Hub.

The Head of Safeguarding reported that it is the responsibility of the providers to manage and operate the services, when services are commissioned contractual standards will include requirements in respect of safeguarding.

Steve Taylor responding to concerns raised in the CQC report in respect of his organisation reported that as a Trust regular audits are undertaken, the systems have improved at the Trust as a result of the inspection and further improvements will be made as part of  ...  view the full minutes text for item HWB.338

Steve Taylor, Chief Officer, Managing Director, Bury & Rochdale Care Organisation, Northern Care Alliance will report at the meeting.  Report attached.

Chief Officer/Managing Director Bury & Rochdale Care Organisation, Steve Taylor attended the meeting to provide members with an update in relation to Pennine Acute NHS Trust’s triage arrangements and winter pressures.  An accompanying report had been circulated in advance of the meeting, containing information in respect of the following areas:

• A&E attendances by triage category
• A&E attendances time to triage
• A&E attendances
• A&E attendances Arrivals
• FGH Performance against Greater Manchester Performance

The Chief Officer reported that there has been a significant upsurge in the numbers of very urgent patients seen within A&E.  Monday 11^th February 2019 was one of the busiest days on record at FGH A&E with almost 260 patients triaged.  The system continues to be under significant pressure, but still manage to maintain patient safety.  This issue is not isolated to FGH but the whole system is struggling across Greater Manchester. 

Responding to a Member’s question, the Chief Officer reported that work has been undertaken to review ambulance attendances and admittances from Nursing homes and to try and support those nursing homes with high levels of 999 calls.  The use of the paramedic green car has deflected 87% of activity away from A&E but there still remains high demand in the system.

Responding to a Member’s question, the CCG Chair reported that a piece of work has been undertaken to assess what will be the health demand going forward taking into account predicated housing building as a result of the GMSF and other demographic factors.

It was agreed:

The Chief Officer/Managing Director Bury & Rochdale Care Organisation, Steve Taylor be thanked for his attendance.

Steve Taylor, Chief Officer, Managing Director, Bury & Rochdale Care Organisation, Northern Care Alliance will report at the meeting.  Report attached.

Chief Officer/Managing Director Bury & Rochdale Care Organisation, Steve Taylor attended the meeting to provide members with an update in relation to the current rates of readmission at Pennine Acute NHS Trust.  An accompanying report had been circulated in advance of the meeting, containing information in respect of the following areas:

• Fairfield General Hospital Readmission SPC chart April 2017 – November 2018
• Fairfield General Hospital compared with North Manchester General Hospital and The Royal Oldham Hospital
• Fairfield General Hospital – Breakdown of the reason for re admission (HRG based most recent 12 months)
• Readmission length of stay & bed days

Members discussed it there were any themes emerging from the readmission figures.  The Chief Officer reported that comparable data could be provided to the Board. 

It was agreed:

The Chief Officer/Managing Director Bury & Rochdale Care Organisation, Steve Taylor be thanked for his attendance and comparable national and regional information will be provided at a future meeting.

Dee Colam, Interim Assistant Director Adult Social Care Operations will present at the meeting.  Report attached.

Dee Colam, Interim Assistant Director (Adult Social Care Operations) provided members with a follow up report in respect of the state of delayed transfers of Care in Bury.  Delayed Transfers of Care are a national Key Performance Indicator (KPI) for both the NHS and Adult Social Care (ASC).  The report included information in respect of delayed transfer of cares in the following areas and measures taken to address the problem:

Mental Health

Acute hospitals

Non-Acute Hospital

Winter Pressures Grant

Members discussed problems with recruitment to the Integrated Discharge Team.  The CCG Chair reported that this was becoming increasingly problematic however work is underway across Greater Manchester to address this issue.

Responding to a Member’s question, the Interim Assistant Director reported that the discharge to assess beds have been very successful at releasing capacity within the Acute sector. This service is now offered on four sites across the Borough, supported by a range of professionals.

It was agreed:

A further update will be provided to the Board in six months.

Dr Jeffrey Schryer, Joint Chair, Transformation Programme Board will report at the meeting.  Report attached.

Dr Jeff Schryer, Chair of Bury CCG’s clinical commissioning board presented a report providing an overview of the work undertaken by the Transformation Programme Board.  Work undertaken has included:

Transformation Models of Care

Primary features of these new services include:

• New standard operating procedures for MDT and Rapid Response
• More effective use of the current bed base to create capacity in the system

·         Understanding the future demand on intermediate care packages

and designing the model around this

·         Creating a single service for the intermediate tier

·         Mutually Binding Agreement

·         Estates for Integrated Neighbourhood Teams

It was agreed:

Health and Wellbeing Board is recommended to note the work of the Health and Care Transformation programme Board

This report will be sent to follow.

It was agreed:

That this item will be deferred and considered at the next meeting of the Health and Wellbeing Board.

Lesley Jones, Director of Public Health will report at the meeting.

·         Nutrition and Hydration Update – Carmel Burke, Nutritionist will also be in attendance.

Lesley Jones, Director of Public Health and Carmel Burke, Nutritionist provided members with a GM population plan update with a focus on Nutrition and Hydration.  The presentation provided an overview of

·Raising Awareness on malnutrition risks and dehydration in the 65+ population across Bury

• Working Together with all willing community services across Bury and training their care staff and looking at further opportunities to support those at risk

• Identifying Malnutrition by using the Paperweight Armband ©

• Personalising Care and Support by providing individuals and care staff with “Are you Eating Enough” booklets

• Monitoring and Evaluating the programme when hitting milestones

Members discussed the late HIV diagnosis figures as referenced in the GM population plan update.  The Director of Public Health reported that Bury are the best performing Borough in GM.  Future plans will include a programme that normalise the treatment of this condition and treated as others that suffer from a Long term condition, this will hopefully include patients being able to receive treatment in the integrated neighbourhood teams.

Councillor Walker raised concerns about the lack of information contained within the GM population health plan with regards to substance misuse services.  The Director pf public health reported that there is a GM Strategy is being developed to address this area.

Responding to a member’s question, The Nutritionist reported that over 800 people have been assessed in Bury using the paperweight armband.