Agenda and minutes

None.

None.

To confirm the minutes of the meeting held on 9 February 2016.

The minutes of the meeting held on 9 February 2016 were agreed as a true record and they were signed by the Chair.

Report of the Vice Chairman of the Joint City and County Health Scrutiny Committee

The Committee considered a wide-ranging report and presentation from Peter Homa, Chief Executive of Nottingham University Hospitals (NUH) NHS Trust, covering the following issues:

NUH response to the Care Quality Commission (CQC) report and rating

(a)  the CQC involved a team of over 60 inspectors on both planned and unannounced visits in September 2015. 8 pathways were inspected:

o  urgent and emergency care;

o  medical care;

o  surgery;

o  critical care;

o  children and young people;

o  maternity and gynaecology;

o  outpatients and diagnostic imaging, and

o  end of life care.

  Inspectors engaged staff and patient focus groups, as well as Executive and Directorate management teams and specialist leads;

(b)  NUH was rated overall ‘good’ by the CQC, with a ‘good’ rating for being ‘effective’, ‘caring’ and ‘responsive’. No major concerns were identified, the Trust received an ‘outstanding’ rating for being ‘well-led’ and a ‘requires improvement’ rating was awarded for being ‘safe’;

(c)  the report highlighted a number of examples of outstanding practice, including in the strong ethos of learning and training, strong partnership working with local schools and public health, elements of dementia care, governance and innovative use of technology, such as the ‘Pocket Midwife’ initiative;

(d)  areas identified for improvement included improving End of Life care, specific staffing issues around children’s provision, specialist training issues around midwifery, critical care, neonates and eye casualty and greater consistency in the application of the Mental Capacity Act, and in documenting emergency equipment checks and do Not Attempt Resuscitation decisions.

The Committee congratulated Mr Homa on the report’s positive outcomes, and noted actions identified to address the issues needing improvement. Mr Homa explained that improving the ‘Safe’ rating was less about safety of patients and more to do with consistency of recording and embedding actions already taken across the Trust. He also confirmed that parts of NUH already operated on a 7-day basis, and that the Trust’s plans to meet 7-day requirements were progressing well.

Partnership with Sherwood Forest Hospitals Trust (SFH)

(e)  NUH had been successful in securing a partnership with SFH following a competitive tendering process, also involving Sheffield and Derby Hospital Trusts. The NUH approach to partnership was respectful, humble and supportive, with an immediate focus on addressing CQC issues and longer term focus on developing a new vision and values for the unified organisation;

(f)  the union between NUH and SFH benefitted both patients and staff. Patients would experience improved clinical outcomes, safety and access to services, while staff would experience greater career, development and education opportunities, stable experienced leadership and enhanced research opportunities;

(g)  union also brought benefits to the wider health infrastructure of Nottinghamshire. Existing joint working would be enhanced, health and social care would be more easily integrated and financial and estate efficiencies could be made;

(h)  work was ongoing to develop governance arrangements, agree timelines for integration, ensure strong and consistent communications and engagement and develop plans.

The following issues were raised during discussion:

(i)  Mr Homa confirmed that the SFH  ...  view the full minutes text for item 62.

The Committee considered a report and presentation updating it on Patient Transport Service performance. The Committee also considered an updated report and presentation from Healthwatch Nottinghamshire on the experience of renal patients using the Patient Transport Service. Representatives from Arriva Transport Solutions (ATS) and commissioners attended the meeting.

Patient Transport Service Performance Update

Arriva Transport Solutions (ATS) representatives Paul Willetts, Director of Governance and Quality, Andrew Cullen, National Head of Patient Transport Services and Philip Hennessey, Communications and Engagement Manager gave a presentation, providing the following information:

(a)  ATS undertook to introduce significant changes to the Patient Transport Service, and in the past 6 months have:

o  Established an Operational Improvement Plan, with a particular focus on 3^rd party provider performance and flexible rostering to match demand;

o  Developed a range of winter pressure readiness measures;

o  Continued to champion Transport Working Groups;

o  Implemented a Renal Improvement Plan, including appointing a Renal Co-ordinator and implementing a missed treatment escalation process;

(b)  councillors went on a visit to the ATS Ashville base to gain a better understanding of the service and the conditions under which it operates;

(c)  there has been significant communications and engagement activity, with renal roadshows delivered across Nottinghamshire, a new patient survey launched, and patient reminder cards and a quarterly stakeholder newsletter published;

(d)  9 out of 10 patients would recommend the service to friends and family, and patient satisfaction with most elements of the service had improved;

(e)  ATS acknowledged that renal dialysis performance required further significant improvement;

(f)  ATS will look to build on recent performance improvements, will continue to work with Healthwatch to inform service improvements and to liaise with NHS staff to explain how the service operates and to minimise disruption to patients.

The following points were made during discussion:

(g)  all 3^rd party providers go through a compliance check and sign up to the Service Level Agreement (SLA). The SLA has been revised in the light of feedback to incorporate consequences of not complying with SLA requirements;

(h)  all performance information used by ATS was channelled through the organisation’s Business Intelligence Unit and was independently collated and verified;

 (i)  the Operational Improvement Plan addressed basic elements within the control of ATS. However, there were a number of issues outside the organisation’s control that impacted on its ability to deliver its services. For example, if a health and social care package was not in place for a patient then the resulting delays impacted on ATS’ performance. Similarly, if a care home had closing ‘cut off’ time then affected patients could be prioritised at the expense of other patients;

(j)  ATS representatives confirmed that winter pressures were less to do with transport conditions and more about the impact of wider pressures on health and social care services on the Patient Transport Service.

Paul Fitzgerald, Patient Transport Service Contract Manager at the Greater East Midlands Commissioning Support Unit (GEM CSU), and Neil Moore, Director of Procurement and Market  ...  view the full minutes text for item 63.

Report of the Head of Democratic Services (Nottingham City Council)

The Committee considered the report of the Head of Democratic Services about the Committee’s work programme for the remainder of 2015/16 and into 2016/17. Jane Garrard, Senior Governance Officer, gave the following update:

(a)  an evaluation report on GP Access Fund Pilots was expected by early March 2016 but has not yet been published, so consideration of this issue is currently on hold;

(b)  Quality Account study group meetings are taking place, with a further round of meetings planned in May/June 2016 to consider final draft Quality Account documentation;

(c)  further to consideration at the Committee’s February 2016 meeting, Transforming Care for People with learning disabilities and/or autism spectrum disorders proposals are currently out for public consultation, and will be considered again at the Committee’s July 2016 meeting;

(d)  the Chair and Vice-Chair held a useful and informative meeting with the Nottinghamshire Regional Manager of EMAS.

RESOLVED to note the report and update.