Agenda and minutes

Councillor Ilyas Aziz

Councillor Eunice Campbell

Councillor Colleen Harwood

Councillor Chris Tansley

Councillor Jacky Williams (sent substitute)

None.

To confirm the minutes of the meeting held on 13 October 2015.

The minutes of the meeting held on 13 October 2015 were confirmed and signed by the chair.

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

Dr Stephen Fowlie, Medical Director and Deputy Chief Executive at Nottingham University Hospitals (NUH) presented an Environment, Waste and Cleanliness update, highlighting the following points:

(a)  between 15-18 September, there was a planned Care Quality Commission (CQC) visit to NUH, following a previous inspection that took place 18 months before.  Following the planned inspection, there was an unannounced visit on 28^th September, which garnered complimentary feedback.  The CQC rating was expected in December, but no major issues of concern had been raised;

(b)  Patient-led Assessments of Care Environment (PLACE) scores relating to the environment including cleanliness, food, privacy, dignity and wellbeing were slightly better in 2015 than in 2014.  At Queen’s Medical Centre (QMC), the dementia PLACE score is currently below the national average, due to the facility not being well suited to patients living with dementia.  Work is progressing to improve the environment for patients living with dementia;

(c)  there is now a dedicated decant ward at QMC. Between ten and twelve wards will be deep cleaned and decontaminated by Christmas 2015.  There was no increase in CDiff cases over the summer when cleanliness issues were raised over the summer; 

(d)  where possible NUH signposts both patients and staff to Smoking Cessation Services and there is focussed targeting of parents of children in hospital. Visitors are encouraged not to smoke at entrances and an enhanced cleaning programme is underway but there is still a way to go to resolve this matter;

Disciplinary measures have been taken against some NUH staff;

The existing smoking policy is being reviewed, including the use of e-cigarettes (hospital policy currently does not include e-cigarettes). Work is also underway with Nottingham City Council to explore the issuing of fines;

  A patient led social media campaign has been highly effective in asking visitors not to smoke;

(e)  behavioural disturbance at night can feature as part of some patient’s condition and is unavoidable.  However, staff are trying to reduce the number of call bells and buzzers on the wards, and have asked families, carers and other staff to refrain from using electronic devices at night.

  There has been a reduction in noise levels generated by bin collection, but there is still further work to do in this area.

Following questions from Councillors and attendees, the following points were discussed:

(f)  the number of staff employed within the cleaning service has increased since  Carillion took over the contract.  A significant improvement plan has been undertaken including specific cleaning training within the team and cleaning supervisors spending more time on wards;

(g)  CQC’s ‘unannounced inspection’ is part of the CQC methodology, so organisations are  prepared and gear up for this. NUH was notified ten working days prior to the visit and were informed that inspectors could potentially visit out of hours services, including weekends and/or during the night. Peter Homa confirmed that CQC inspectors speak to 1000’s of patients during their visits;

(h)  PLACE scores do not include external quality assurance so it is very difficult to  ...  view the full minutes text for item 37.

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

Christine Richardson, and John Wallace, presented the report on The Decommissioning of the Dangerous and Severe Personality Disorder Service (DSPD) at Rampton Hospital, highlighting the following points: 

(a)  the facility at Rampton currently has capacity for 115 patients,, currently there are 100 patients in beds; 

(b)  NHS England is running a modelling tool which has been developed by Nottingham University and which should be completed by December 2015.

   It is currently forecast that Rampton will close a ward by October 2017. 

(c)  there is a guiding principle regarding the patients interests.  If a patient thinks that something is awry in the way they are being treated, their advocates and solicitors will be consulted;

(d)  Rampton is a top-level secure hospital.  The main routes in are through the courts system, or admission from a lower level security hospital.  On discharge, the patient would move back down the system, or alternatively, back through the prison service if that was their route in.  Very occasionally, high security hospitals might transfer patients (if there has been collusion for example).

RESOLVED to:

(1)  note the report;

(2)  arrange a visit to the facility for interested members before the next presentation at this Committee.  To be organised through Martin Gately;

(3)  come back with a detailed presentation in February.

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

Vicky Bailey, Chief Executive of Rushcliffe Clinical Commissioning Group (CCG), introduced the Dermatology Action Plan monitoring report.  The following points were highlighted:

(a)  local health partners continue to collaborate, and the structures in process around dermatology are constantly fine-tuned.  An audit from NUH predicted small transfers of patients to Leicester, and this is what is being seen;

(b)  national training places of Dermatologists will not be growing in the medium term, so Dermatologists will need to be attracted to Nottingham from other areas;

(c)   work is ongoing  to protect the existing Paediatric Dermatology Service;

Following questions from members, the following points were highlighted:

(d)  from an adult service perspective, waiting times naturally increase over the summer period. Currently, the wait is around 3 months for a general appointment. All CCGs are now engaged in Tele Dermatology with 70% of patients remaining in primary care.  22% of patients have been converted to a two week wait;

(e)  patient experience and feedback seems to be consistently high;

(f)  1 consultant has been attracted to Nottingham.  In addition to this, 5 training grades to work across the region have also been approved;

(g)  Healthwatch reported that it had attended a one off Dermatology Action Group involving patients; a Memorandum of Understanding between organisations has been developed and monthly meetings are taking place to discuss progress, but this may not continue if no new Dermatologists can be recruited.

RESOLVED to:

(1)  ask a further report to come back to the Committee in five months’ time;

(2)  write to the Secretary of State as a Committee highlighting concerns regarding the demise of Dermatology services in Nottingham.

Report of Head of Democratic Services.

The Committee considered the report of the Head of Democratic Services regarding the Committee’s work programme for 2015/16.

(a)  Rampton Secure Hospital Variations of Service presentation to be delivered to the Committee in February 2016;

(b)  Long Term Neurology Conditions item will be deferred to March 2016;

(c)  An update on the Dermatology Action Plan will be presented to the Committee in April 2016.

RESOLVED to note the Work Programme, subject to the addition of the above items.