MIDDLESBROUGH AND ESTON HEALTH SCRUTINY JOINT COMMITTEE
A formal notice had been issued to all concerned of a meeting of the Middlesbrough and Eston Health Scrutiny Joint Committee to be held on 13 September 2005. At the appointed time of 2.00 p.m. the following were present: -
PRESENT: Representing Middlesbrough Council
Councillor Davison
Representing Redcar & Cleveland Borough Council
Councillors Mrs Collins and Mrs Franklin.
OFFICIALS: J Bennington and J Ord (Middlesbrough Council) and C Moon (Redcar & Cleveland Borough Council).
PRESENT BY INVITATION: Representatives from Middlesbrough PCT:
P Connor, S Greaves, J Maloney and M Thornton.
The agreed protocol of the Middlesbrough and Eston Health Scrutiny Joint Committee states that the ‘quorum of the Joint Committee shall be four, including at least one representative from Redcar & Cleveland Borough Council’.
Given the nature of the business to be transacted and the number of external witnesses in attendance it was agreed to proceed on an informal basis.
Councillor Mrs Franklin (Vice-Chair) (Redcar & Cleveland Borough Council) took the Chair for the meeting.
** APOLOGIES FOR ABSENCE were submitted on behalf of the Chair (Councillor Dryden) and Councillors Ferrier and Mrs H Pearson (Middlesbrough Council) and Councillor Blott (Redcar & Cleveland Borough Council).
** DECLARATIONS OF MEMBERS’ INTEREST
Name of Member Type of Interest Item/Nature of Interest
Councillor Mrs Collins Personal/Non Prejudicial Any matters relating to Langbaurgh PCT
Councillor Mrs Franklin Personal/Non Prejudicial Any matters relating to TNEY NHS Trust.
** MINUTES
Subject to the formal approval of the Joint Committee the minutes of the meeting of the Middlesbrough and Eston Health Scrutiny Joint Committee held on 10 August 2005 were submitted and approved.
HEALTHCARE COMMISSION – BETTER STANDARDS – HEALTH CHECK PROCESS – MIDDLESBROUGH PRIMARY CARE TRUST
In a report of the Scrutiny Support Officer information was provided on the Healthcare Commission’s Better Standards Health Check and sought a response to Middlesbrough PCT’s self assessment.
The Healthcare Commission existed to promote improvements in the quality of healthcare and public health through independent, authoritative, patient centred assessments of the performance of those who provided services. In England, the Healthcare Commission was responsible for reviewing the performance of each local NHS Trust and awarding an annual rating of the performance of the organisations.
Reference was made to the aim of the review process, which was to assess compliance with the Department of Health’s 24 core standards, which were divided up into 7 domains of activity. The performance of NHS Trusts would be assessed over a 12-month period each year from 1 April to 31 March based on a self declaration which stated that the Board had received reasonable assurance that the Trust had complied with the core standards without significant lapses.
It was noted that the Healthcare Commission had indicated that members of overview and scrutiny committees were ‘not expected to have in depth, expert knowledge about all the services that a trust was providing and is being assessed on’ but the aim was to focus on providing a ‘reality check’ on the assessment and to demonstrate the links between services and the experience of local people.
The report submitted gave an indication of the most relevant core standards.
Mr J Maloney, Head of Health Care (PCT) gave a presentation, which focussed on the following:
· The draft statement as at 5 September on the standards for better health scoring on the 7 domains with 24 core standards involving 84 criteria and an additional 13 Developmental Standards to be incorporated in April 2006.
· Draft timetable to enable compliance with Standards for Better Health and leading to a Final Declaration of Conformity in April 2006.
· Framework of assessment.
· Process adopted in formulating evidence.
· Current position, which outlined achievements to date, and action plans produced to ensure compliance.
· Example given of the risk ratings of the 7 domains in particular those relating to patient Focus and Public Health.
Members sought clarification on a number of elements and discussed the opportunity to submit any contribution towards the draft declaration.
AGREED as follows: -
1. That Mr Maloney be thanked for the information provided.
2. That based on the written material provided to the Panel and additional information arising from the meeting, a draft strategy be prepared by the Scrutiny Support Officer to be circulated to the Panel for comment and approval.
RESPITE AND PALLIATIVE CARE FOR INFANTS WITH A LIFE LIMITING ILLNESS – TERMS OF REFERENCE
Further to the meeting of the Joint Committee held on 10 August 2005 and in a report of the Scrutiny Support Officer the draft terms of reference for a review into the current provision of respite and palliative care service for infants with life limiting illnesses in the Middlesbrough Primary Care Trust was reported as follows: -
a) To examine the current level of service provision.
b) To research the prevailing national policy on the subject.
c) To establish what duties, if any, are placed upon the local NHS bodies and local authorities in relation to the subject.
d) To establish the current level of need for such services and whether the need is being adequately met.
e) To establish whether there is a need for development in current service provision and to what extent any required developments can be achieved.
f) To take evidence from as wide a range of stakeholders as possible.
g) To prepare, agree and publish a report detailing the evidence considered and making any recommendations considered appropriate to put to the relevant organisation (s).
AGREED that subject to the formal approval of the Panel, the terms of reference for the review into the current provision of respite and palliative care services for infants with life limiting illnesses in the Middlesbrough Primary Care Trust as outlined be approved.
RESPITE AND PALLIATIVE CARE FOR INFANTS WITH A LIFE LIMITING ILLNESS – PRIMARY CARE TRUST
The Scrutiny Support Officer submitted an introductory report and gave an indication of the elements on which the PCT had been asked to provide preliminary evidence.
The key points arising from the presentation and subsequent discussion were as follows: -
PCT Responsibilities:
a) to commission high quality palliative and respite healthcare services for infants and children with life limiting illness, provided by a range of people in a variety of settings including home, hospital and hospice;
Definition of Palliative Care:
b) the active total care offered to a patient with severe progressive life-limiting illness and their family, when curative treatment is neither possible nor appropriate and the focus of care is quality of life and alleviation of distressing symptoms;
Definition of Respite Care:
c) short term, temporary care provided to people with severe disabilities, chronic or terminal illness, and is designed to give families a break form the stress of daily caregiving;
National Guidance:
d) the Children, Young People and Maternity Services national Service Framework together with other national documents such as NICE, Improving Outcomes in Children and Young People with cancer 2005, and NICE Improving Supportive and Palliative care for Adults with cancer 2004 had set out a framework and clear standards for health and social care to achieve;
Current Level of Service Provision:
e) it was noted that a number of infants and children with life limiting illness were treated at specialist regional centres (Newcastle and Leeds) and it was considered in some areas that it was a reactive service;
f) the PCT was keen to ensure a seamless service was begin offered to this group of parents and were undertaking a mapping exercise to identify children with a complex or additional health care need within the Middlesbrough PCT area;
g) it was intended to identify referral process, criteria and relationships with other service providers and transitional pathways;
h) a list of services for children with complex needs/ palliative care was provided in Appendix 1 of the report submitted;
i) the emerging findings from such work had highlighted two specific gaps in care namely; respite care (particularly for children without a learning difficulty) in day care, residential care and within the family home; and transition into adult services;
PCT’s Contribution:
j) with the exception of the James Cook University Hospital Paediatric Palliative care Team the PCT contributed to all NHS Services through relevant contracts;
k) although the Paediatric Palliative Care Team, an outreach service, was currently funded through Big Lottery Funding which expired in 2006, the PCT were currently working with colleagues at James Cook University Hospital to evaluate the service wit a view to provide ongoing funding;
l) services provided by the voluntary sector were currently paid for on a cost-per-case basis and the PCT was working with both Zoe’s Place and the Butterwick Children’s Hospice to agree a Service Level Agreement;
m) it was noted that work was also progressing with Local Implementation Teams with regard to possible funding streams to identify the level of support needed in respect of Zoe’s Place;
Level of Need for Service:
n) the PCT was in the process of producing a strategy for palliative care services, a part of which would be to undertake a health needs assessment.
AGREED that the representatives from the PCT be thanked for the information provided which would be incorporated into the overall review.
ESTON HEALTH AND SOCIAL CARE VILLAGE
In a report of the Scrutiny Support Officer the Joint Committee was advised of proposals for a Health and Social Care Village the formal consultation period for which had commenced and had so far involved 11 open public meetings, 22,000 registered patients and 17,000 constituents in 6 electoral wards. It was noted that a positive response had been received so far.
Middlesbrough PCT was leading on a project entitled a Health & Social Care Village, planned for the ‘Greater Eston’ area including 4 GP practices. Whilst the site of the new facility would be based within the boundaries of Redcar & Cleveland Borough Council, the services to be provided at the facility would be accessed by residents from both local authorities.
As part of department of health guidance on developments in health services, the PCT was obliged to consult with local stakeholders on the development and take views into account when considering such plans.
AGREED that further evidence be sought on the proposed Health and Social Care Village in order to assist in formulating a response to the formal consultation.
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