Agenda and draft minutes

To note the appointment of Vice Chair

The Committee noted that Councillor Anne Peach has been appointed Vice-Chair of the Committee for 2016/17.

To note the appointment of Councillor Joyce Bosnjak to the membership of Joint City and County Health Scrutiny Committee

The Committee noted the appointment of Councillor Joyce Bosnjak to the membership of the Committee for 2016/17.

Councillor Merlita Bryan – Council business

Councillor Eunice Campbell – unwell

Councillor John Handley

Councillor Colleen Harwood

Councillor Corall Jenkins – Personal

Councillor Brian Parbutt – work commitments

None.

To confirm the minutes of the meeting held on 19 April 2016

Subject to recording Councillor Cutts’ attendance at the meeting, the minutes of the meeting held on 19 April 2016 agreed as a true record and they were signed by the Chair.

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

Nottingham Healthcare Trust representatives Simon Smith, Executive Director Local Services, and Gary Eves, Programme Development Manager, introduced a report and short film, updating the Committee on plans for a new facility to deliver both Child and Adolescent Mental Health Services (CAMHS) and Perinatal Mental Health Services in Nottingham.

Mr Smith and Mr Eves made the following points:

(a)  proposals for establishing a modern, fit for purpose CAMHS and perinatal facility in Nottingham were drawn up in early 2015, and formal consultation took place throughout the summer of 2015, with 85% of respondents supporting the proposals;

(b)  the Trust’s Board of Directors approved the business case in September 2015, planning consent has been secured for the proposed site on Foster Drive, off Mansfield Road, and the contract to build the facility has been signed. Construction is scheduled to complete in February 2018, with services delivered on-site shortly after;

(c)  the expected benefits include improved fit for purpose facilities offering therapeutic caring environments and increased bed capacity for those requiring specialist inpatient care, meaning fewer children and young people having to travel out of area to access services;

(d)  Nottinghamshire Healthcare Trust is in discussions with Nottingham City Council about the provision of education within the perinatal mental health facility, as the site falls within the Nottingham City boundary.

The Committee welcomed the significant progress made since it last considered the issue in July 2015, and was very positive about the design and site layout as presented in the short film. The Committee requested a further update for May 2017, and following issues were raised in discussion:

(e)  Mr Smith and Mr Eves confirmed that the new facility will be built to the highest sustainability specifications, and that the business case fully considered sustainability and maintenance issues;

(f)  Mr Smith explained that the current Thorneywood site has 13 beds, while the new facility will have 30 beds, serving all Nottinghamshire and Derbyshire. He also agreed that having more effective lower-level intervention was key to preventing service users’ conditions escalating to requiring inpatient services, and expressed the view that the new integrated CAMHS offer will help deliver this;

(g)  Mr Eves explained that the Trust has a comprehensive Strategic Workforce Plan under which sat a Workforce Model, identifying the required skills mix to deliver the Trust’s objectives. The Workforce Plan was also informed by the Trust’s Organisational Development Plan and Recruitment and Retention Plan, which set out the organisation’s mission, values, and education, training and personal development needs. Mr Eves offered to update the Committee on recruitment issues as part of the May 2017 update;

(h)  Mr Smith confirmed that funding of the education element of the facility still needed clarifying, and that the Department for Education are being lobbied to press for pupil funding to be increased proportionately to the increase in bed capacity. An update will be included in the May 2017 progress report;

(i)  the Committee requested a progress report on the updated integrated CAMHS model for consideration  ...  view the full minutes text for item 77.

Report of the Vice-Chair of the Joint City and County Health Scrutiny Committee

Dr Christine Johnson and Jan Dixon of Derbyshire Health United, and Helen Jones, Head of Urgent Care Nottingham City Clinical Commissioning Group introduced a report updating the Committee on the performance of the NHS 111 service, making the following points:

(a)  the current service provider, Derbyshire Health United (DHU), had its contract initially extended until October 2016 so that the tendering process could be completed. The new NHS 111 service contract will be delivered by a consortium made up of DHU and EMAS;

(b)  performance in respect of the number of calls answered within 60 seconds has improved, and is consistently higher than the national average, but has not met the target of 95%;

(c)  the numbers of callers advised to attend an emergency department or been sent an emergency ambulance is broadly in line with national statistics;

(d)  the numbers of nurse callbacks, and the time taken to call back remains a cause for concern. A priority identification process has been introduced to ensure resources are targeted at those most in need;

(e)  patient experience feedback continues to be positive, with 35% of respondents indicating that they would have gone to Accident and Emergency (A&E) or dialled 999 if they had not contacted the NHS 111 service.

During discussion, the following points were made:

(f)  it is difficult to recruit nurses to the NHS 111 service and, even if successful, there are substantial notice periods and training programmes to complete before recruits can be used;

(g)  areas identified for improvement include smarter technological modelling to predict patient behaviours and peak periods, greater use of pharmacists within the system as 20% of calls are medication-related, and working harder to retain staff, primarily through internal development;

(h)  under the new contract from October 2016 there will be an integrated urgent care approach to signpost patients appropriately;

(i)  7-10% of calls are dental related, and there will be more dental advisors available under the new contract. Healthwatch colleagues welcomed this development as it was currently difficult to access out-of-hours urgent dental care;

(j)  there is a national conversation on the principle of ‘Call before you go’ so that patients get appropriately signposted to the relevant service and do not end up attending A&E as a default;

(k)  the least favourable feedback from service users was about delays in providing callback advice, but recent performance has improved significantly.

RESOLVED to note the report and verbal update, and to request a further update in May 2017 to scrutinise performance under the new NHS 111 service contract.

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 workload in 2016/17. Jane Garrard, Senior Governance Officer, introduced the report, and the Committee suggested a number of amendments to and inclusions within the work programme during the discussion which followed:

(a)  a CAMHS update in July or September 2016, with a review of on-site progress for the new CAMHS facility in May 2017;

(b)  an update on the NHS 111 service in May 2017;

(c)  Ms Garrard informed the Committee that the Care Quality Commission has just published its inspection report on the East Midlands Ambulance Service (EMAS). The report highlighted a number of shortcomings, including around staffing and handover times, though the latter was less of an issue in Nottingham City and County. The Committee acknowledged the challenges facing EMAS, and welcomed the suggestion of having an informal meeting of the region’s Health Scrutiny chairs to discuss with EMAS how they intend addressing those challenges;

(d)  the Committee requested that the Chief Executive of Nottingham University Hospitals Trust attend a Committee meeting in January or February 2017 to consider emergency pathway planning;

(e)  in response to a comment from Healthwatch Nottingham, Ms Garrard advised that the City Council’s Scrutiny Committee will consider City-specific GP issues at a forthcoming meeting.

RESOLVED to note the work programme and suggested updates.

To agree to meet on the following Tuesdays at 10:15am at County Hall, West Bridgford:

·  14 June 2016

·  12 July 2016

·  13 September 2016

·  11 October 2016

·  8 November 2016

·  13 December 2016

·  10 January 2017

·  7 February 2017

·  14 March 2017

·  18 April 2017

RESOLVED to meet on the following Tuesdays at 10.15am at County Hall, West Bridgford:

2016 – 14 June; 12 July; 13 September; 11 October; 8 November; 13 December.

2017 – 10 January;7 February; 14 March; 18 April.