Apologies were received from Councillor Fox. Councillor Payne attended the meeting on her behalf.

To confirm the record of the meetings and special meetings of the Adults and Health Scrutiny Committee held on 19 September 2019, 7 November 2019 and 29 January 2020.

The minutes of the meetings and special meetings of the Adults and Health Scrutiny Committee held on 19 September 2019, 7 November 2019 and 29 January 2020, copies of which had been previously circulated, were confirmed.

In accordance with the Regulations, Members are invited to declare any personal or prejudicial interests they may have and the nature of those interests in respect of items on this Agenda and/or indicate if Section 106 of the Local Government Finance Act 1992 applies to them.

Councillor Harvey declared an interest in item 8 on the agenda as she had a  close family member who received district nursing services.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 217.

The total time allowed for this item shall be 30 minutes.  Petitions, declarations and questions shall be dealt with in the order in which they are received.  Questions may also be submitted at short notice by giving a written copy to the Committee Administrator 15 minutes before the start of the meeting.

The total time allowed for questions at short notice is 15 minutes out of the total time of 30 minutes.  Any petitions, deputations and questions that have been submitted with prior formal notice will take precedence over questions submitted at short notice.  Any questions that are not considered within the time limit shall receive a written response after the meeting and be the subject of a report to the next meeting.

A deputation relating to item 9 on the agenda, the East Midlands Ambulance Service, had been received from the very Reverend Christopher Armstrong, Priest-in-charge, The Welland-Fosse Benefice.

The Chair requested that the deputation be delayed so that it could be read out just before agenda item 9 and addressed directly to Mr Bentnall, the representative form the East Midlands Ambulance Service. The Committee were in agreement.

To consider any questions with notice from Members received in accordance with the provisions of Procedure Rule No 219 and No 219A.

No questions with notice had been received from Members.

To consider any Notices of Motion from Members submitted in accordance with the provisions of Procedure Rule No 220.

No notices of motion had been received from Members.

To consider any matter referred to the Committee for a decision in relation to call in of a decision in accordance with Procedure Rule 206.

No matter had been referred to the Committee for a decision in relation to a call-in of a decision in accordance with procedure Rule 206.

To receive a presentation from Rachel Dewar, Head of Community Health Services.

A presentation (appended to the minutes) on District Nursing Services was given by Rachel Dewar, Head of Community Health Services and Tamsin Hooton, Director of Service Redesign and Integration at West Leicestershire CCG.

During discussion the following points were noted:

·         Following a system wide redesign, Community Health Services had been organised into three areas; the Integrated Neighbourhood Team, Home First, and Community Bed Based Care, all of which linked with each other and through a Locality Decision Unit.

·         Community bed based care was strictly for patients who required 24 hour nursing care. Below that level of care was the home first pathway which offered intensive short term care for up to six weeks with integrated health and social care support.

·         The Integrated Neighbourhood Team, which included the District Nurses, worked alongside staff from social care and GP Practices to offer better continuity of care for patients in the community.

·         Rutland and Leicestershire were one of the accelerated sites of the Ageing Well Programme looking at different models to optimise care, including how patients accessed care, how care was dispatched and ensuring rapid reablement services for patients within 48 hours of leaving hospital.

·         There were 25 primary care networks across Leicester, Leicestershire and Rutland (LLR) and the 8 community hubs that sat above these each managed between 3 and 5 of these networks.

·         The East North Hub was based at Melton Hospital but had a satellite base at Rutland Memorial Hospital.

·         Although the Primary Care Networks (PCN) were consolidated into hubs they were still close enough to give a timely response whilst at the same time maximizing the effectiveness of resource.

·         Clinics operated locally in Rutland at the Rutland Memorial Hospital.

·         The new structure only came into place on 1 December 2019 so it was still very early days in which to assess the impact of the changes. However, although there was only 1 full month of hospital data it did show that there had been a dip in admissions which was very encouraging.

·         A workshop would soon be taking place to encourage further interfacing between the Community Health services team and the Rutland Care team.

·         The redesign was about giving the right care in the right setting, looking after people where they needed to be, and reducing hospital admissions.

·         Longer term needs would still be looked after by district nurse services but as there were now more staff, patients would continue to receive care from the same team they had been used to.

·         Councillor Powell asked what difference the reorganisation would make for the patient and how the outcomes were going to be measured.

·         As care would now be organised collectively and jointly throughout their care needs journey, patients could be confident that they were receiving the best care and that they would be getting a quicker response time.

·         The improved service could now provide 7 day therapy and allowed for more patient contact. Waiting times were shorter and this had been evidenced to improve recovery.

·         Readmissions were now being  ...  view the full minutes text for item 582.

To receive a presentation from Lee Brentnall, Ambulance Operations Manager for Communications, Engagement and Safeguarding.

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Before the presentation on the East Midlands Ambulance Service, Reverend Christopher Armstrong read out his deputation (appended to the minutes) to the Committee. 

In response to a question from Councillor Waller, Reverend Armstrong confirmed that the people who had suffered falls and experienced long wait times were very elderly, with some in their nineties.

The Chairman gave Mr Brentnall an opportunity to respond to the deputation at this point in time and Mr Brentnall asked Reverend Armstrong to accept his apologies that he had not received a reply to his original letter to the Chief Executive. The rest of the points that had been made in the deputation would be addressed in the presentation. 

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Following the deputation a presentation on the East Midlands Ambulance Service (appended to the minutes) was delivered by Lee Brentnall, Ambulance Operations Manager for Communications, Engagement and Safeguarding.

During discussions the following points were noted:

·         Category 4 calls were less urgent and were often referred on to other providers such as GPs and Pharmacists. These calls related to those who had illnesses such as diarrhea or vomiting, or who had urine infections. 

·         In the future there would be greater collaboration with the Community Health team as, if they could now guarantee a service within two hours for certain conditions, it would avoid the need to take patients to hospital.

·         130 additional staff had been recruited across a two year period which enabled more ambulances than ever before to be out on the roads. Despite this, targets could still not be met because of handover performance and the amount of time lost waiting outside a hospital.

·         Although delays in handover was a national problem, it was exacerbated in Rutland because it was surrounded by some of the worst performing hospitals in the country. This was an NHS problem that needed to be tackled by working together more closely.

·         Of the 999 calls received, only 50% were taken to hospital. The rest were given urgent appointments or sometimes, after arrival on the scene and assessment, did not end up going to hospital at all. The workforce were skillful in their assessments and were able to leave more people, safely, in their own homes.

·         Ambulance staff arrived at hospital right up to the end of their shifts. If they then had to wait 4 hours to drop off their patient their working day was greatly extended. This had a knock on effect because the working time directive meant staff had to have an 11 hour break which resulted in the service being understaffed the next day. Winter 2019/20 had been the worst ever for delays.

·         A ‘pod’ facility which held up to 10 patients had been put in place as a temporary winter pressures measure which meant that ambulances could offload and get back on the road. However there was very strict guidance on when this measure could be deployed.

·         Rutland army and community responders attended 4000 emergency calls across Leicester, Leicestershire and  ...  view the full minutes text for item 583.

To receive an overview of elements of the Corporate Plan that pertain to the Adults and Health Scrutiny Committee and to identify areas for future scrutiny input. A copy of the Corporate Plan is attached.

Officers and the Portfolio Holder were asked to identify areas of the Corporate Plan for future input by the Adults and Health Scrutiny Committee.

During discussion with the Committee the following points were noted:

·           Councillor Walters, Portfolio Holder for Safeguarding – Adults, Public Health, Health Commissioning & Community Safety asked the Committee for input into the refresh of the Safer Rutland Partnership Plan. This had been due to go out for public consultation but because of the upcoming Police and Crime Commissioner election in May and the restrictions of Purdah, this element would be delayed.

·           Health care provision across the county, including for the proposed new developments at St George’s Barracks and Stamford North, was another area proposed for the new municipal year’s scrutiny work plan.

·           John Morley, Deputy Director for People asked whether any issues that the Committee wished to discuss further be emailed to him to help inform future agenda setting meetings. 

To consider the current Forward Plan and identify any relevant items for inclusion in the Adults and Health Scrutiny Committee Annual Work Plan, or to request further information.

The Forward Plan is available on the website using the following link:

https://rutlandcounty.moderngov.co.uk/mgListPlanItems.aspx?PlanId=253&RP=133

Items for the work plan had been discussed under the Corporate Plan agenda item and therefore no further discussion was had.

To receive any other items of urgent business which have been previously notified to the person presiding.

No items of urgent business had been previously notified to the Chairman.

Thursday 16 April at 7pm.

The next meeting of the Adults and Health Scrutiny Committee would be held on Thursday 16 April 2020 at 7pm.