Agenda and minutes

Councillor Merlita Bryan – illness

Councillor Azad Choudhry – non-Council business

RESOLVED to note the resignation of Councillor Wendy Smith from the Health Scrutiny Panel.

None

To confirm the minutes of the last meeting held on 29 January 2014

The Panel confirmed the minutes of the meeting held on 29 January 2014 as a correct record and they were signed by the Chair.

Report of the Head of Democratic Services

The Panel considered a report of the Head of Democratic Services regarding how complaints are handled in the NHS, with a particular focus on Nottingham CityCare Partnership.

Kate Whittaker, Head of Patient and Public Engagement and Lucinda Cumpston at Nottingham CityCare Partnership, presented the report highlighting the following:

(a)  the service has been running since April 2011 and in that time a total of 132 complaints have been reported. This relatively small number is reflective of the nature of the service as well highlighting that complaints are often dealt with in different ways. In many cases where issues can be dealt with immediately they are often recorded as ‘concerns’ and only become formal complaints where an issue is considered to be of a serious nature;

(b)  in comparison to the number of complaints, the service has receives 15 ‘concerns’ on a quarterly basis and 20-25 compliments per quarter. The service has captured limited data in relation to ethnic origin and disability because it is difficult to ask questions relating to these parameters via a telephone conversation with a distressed member of the public;

(c)  the majority of complaints received relate to treatment and care and two complainants have approached the Ombudsman. Of these two cases, so far the Ombudsman have upheld the process followed by Notts CityCare;

(d)  the process is managed by a dedicated complaints officer who operates as a first point of contact. Contact details for the complaints service is included in a range of literature and staff members are briefed to respond to complaints appropriately. Service users are encouraged to use the complaints procedure;

(e)  dedicate complaints officers will encourage responsible managers to hold face to face meetings with complainants where it is proportionate to do so. All response letters are screened by the Director of Operations and Nursing and contact details for the Ombudsman service is included for complainants. Although relevant team managers investigate complaints, independent investigators are appointed if significant risk is identified;

(f)  as part of the governance process, information on all complaints are collated on a quarterly basis and reported to the Governance and Risk Committee;

(g)  planned improvements to the service includes ensuring that a proportionate response is given where possible. Where complaints are able to be resolved quickly and easily the service will consider providing a rapid response;

(h)  the service will look to develop a web based system that can be accessed by investigated team managers ensuring a quicker and more efficient process. Further planned improvements include ensuring that a satisfaction survey is sent to all complainants when a complaint is closed and to improve the collection of demographic data.

Following questions and comments from the Panel, the following information was provided:

(i)  when a complaint is received, CityCare will initially establish whether it relates to a CityCare service provision and not only sign-post complainants but ensure that the appropriate service contact the complainant. Where a complaint refers to a number of providers, including CityCare, they will  ...  view the full minutes text for item 46.

Verbal update from the Chair of the Health Scrutiny Panel

Councillor Ginny Klein, Chair of Health Scrutiny Panel, verbally updated the Panel on South Notts Transformation following a recent meeting with Clinical Commissioning Group’s (CCG) from Nottingham City, Nottingham North and East, Nottingham West and Rushcliffe.

The Chair highlighted the following information:

(a)  the South Notts Transformation Board worked in groups on how to tackle the impending rises in costs for acute care and adult social care. Currently the deficit is £8m but this is expected to rise to £100m by 2017 due to a range of issues such as the ageing population and associated factors;

(b)  during the session, workshops were split into the following four groups: reactive, proactive, urgent care and children’s care. The group with a ‘reactive’ focus included a number of GP’s with concerns inevitably focussing on the need to move resources from acute care to primary care. Currently there is a deficit of almost 400 GP trainees each year and whilst training practice nurses to do more is possible there is no funding for this at the moment.

Following comments from the Panel, the following additional information was provided:

(c)  Ruth Rigby, Managing Director of Healthwatch Nottingham confirmed that following the formation of the Public Accountability Board a further meeting.

RESOLVED to

(1)  note the update on the South Notts Transformation Board;

(2)  report the Panel’s concern over the disparity of GP practices in Nottingham who are either not informing or offering patients the Annual Health Check, via the appropriate forum;

(3)  engage with GP’s to ensure that they offer Annual Health Checks to their patients.

Report of the Head of Democratic Services

Angelika Kaufhold, Overview and Scrutiny Coordinator, presented a report of the Head of Democratic Services, outlining the Panel’s work programme. During discussion, the Panel were of the opinion that further information on the following projects would be welcome:

(a)  Dr First pilot –where patients talk to their Dr over the phone first to receive advice and if they actually need an appointment;

(b)  Family Nurse Partnership – there have been reports that children are entering school at a reduced developmental stage and that schools do not appear to be aware of the Family Nurse provision. Clarity on whether this scheme is actually making a difference and to explore the ongoing concerns that children are developmentally not ready to go to school;

(c)  School Nurse review – following concerns regards a shortage of school nurses in Nottingham, the Panel would like to establish the reasons for this disparity;

(d)  Mental health beds shortage – Following reports of mental health bed shortages which force patients out of the city, the Panel requested an update on the wider factors determining access to mental health beds in the city;

(e)  the Panel requested an update on the transition procedures from Child and Adolescent Mental Health Services (CAMHS) to adults services and the issue of young people with easting disorders being sent to Leicester for treatment.

RESOLVED, subject to the addition of an update on:

-  Dr First pilot

-  Family Nurse Partnership

-  School Nurse Review

-  Mental Health bed shortages

-  the transition from CAMHS to Adult Service Provision

to note the work programme.

Report of the Head of Democratic Services

Maria Principe, Director of Primary Care Development and Service Integration, Nottingham City Clinical Commissioning Group presented the report of the Head of Democratic Services in relation to the future of Walk in Centres in Nottingham and whether proposed changes to Walk in Centres in Nottingham constitute a ‘substantial variation or development’ in service, highlighting the following information:

(a)  there are currently two walk in centres in Nottingham city centre, the NHS Walk in Centre on London Road which operates from 7 am to 9 pm every day and the 8 am – 8 pm Health Centre on Upper Parliament Street, which also operates everyday. Both contracts are due to end April 2015 and in line with EU procurement regulations a review will take place which will look at contracts;

(b)  the annual cost of the Walk in Centre equates to £20.96 per patient and £38 for an out of region patient. There is no cross charge for Nottinghamshire County or out of area patients at the 8 – 8 centre;

(c)  the 8 – 8 centre offers a primary medical service which includes cervical screening, vaccinations, maternity services and minor surgery. The remainder of the service operates on a drop-in basis;

(d)  there is currently an element of duplication of service as many patients will use the Walk in Centre instead of a GP service. A dental service is however commissioned separately. A snap shot of activity at the Walk in Centre suggests that the majority of day patients visit on Sundays;

(e)  a survey of 733 patients highlighted that 69% felt that visiting the Walk in Centre was their first choice. In the Walk in Centre was not open, 58% would visit their GP and 34% would visit their accident and emergency department. When asked why patients chose the Walk in Centre, 29% said it was because no appointments are required, whereas 19% felt that visiting the Walk in Centre was convenient for their working arrangements. Of the 733 patients surveyed, 48% resulted in self-care at home, 27% resulted in treatment plus a prescription and 13% were directed to immediate care;

(f)  findings thus far suggest that patients currently use the Walk in Centre as an extension of primary care services and the assumption would be that the majority of service users choose the Walk in Centre as their 1^st choice because of convenience. There is a clear duplication between the 8 – 8 service and the Walk in Centre which equates to double payments for GPs, the Walk in Centre and the 8 – 8 service. In the event that the Walk in Centre was closed, an increased amount of resource would be available across the Health Community;

(g)  feedback amongst NHS Nottingham City GP members highlighted a strong feeling that a city based resource was needed however agreed that there is a duplication in provision in both the Walk in Centre and the 8 – 8 provision. Following a SWOT analysis of options, the feeling amongst  ...  view the full minutes text for item 49.