Council and councillors

Apologies were received from Mrs R Powell

To confirm the record of the meetings of the Adults and Health Scrutiny Committee held on 1 April 2021 and 28 April 2021 (previously circulated).

The minutes of the meetings held on 1 April and 28 April 2021 were confirmed as accurate records.

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.

No declarations of interest were received.

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. 

Miss Narey confirmed that a question, in two parts, had been received from Mr Ramsay Ross. He was unable to attend the meeting, but his question had been added to the website and circulated to committee members in advance of the meeting.  A written response would be sent to Mr Ramsey and this would be included with the minutes of the meeting.

Question for Adults and Health Scrutiny Committee Meeting: 17 June 2021

Received from Mr Ramsay Ross

Context:

The January Minutes of the Health & Wellbeing Board state that the CCGs have an  absolute ambition to deliver a Rutland Plan and that they are committed to having consensus about what is important in the shaping of such a Plan.

Question, in two parts

How will the Rutland Adult & Health Scrutiny Committee execute its primary aim of strengthening the voice of local people, such that we can be assured that:

(i) our needs and experiences are considered as an integral part of the commissioning and delivery of health services; and

(ii) that a mechanism will exist to permit public recommendations for the improvement of existing services to be submitted for consideration

Response:

It was RESOLVED that a draft Place Led Plan be PRESENTED to the Adult and Health Scrutiny Committee on the 9th September 2021 before it was presented to the Rutland Health and Wellbeing Board on the 5th October 2021.

Deputation for Adults and Health Scrutiny Committee Meeting: 17 June 2021

A deputation was received from the Rutland Health and Social Care Policy Consortium and this was delivered by Mrs Reynolds.

Cllr Harvey thanked Mrs Reynolds for her deputation and asked Members if they had any questions regarding the deputation.  Cllr Cross confirmed his agreement with the deputation from Mrs Reynolds and the Rutland Health and Social Care Policy Consortium.  Cllr Waller enquired what the Consortium expected the Adults and Health Scrutiny Committee to do when the matter was being undertaken by the Leicester, Leicestershire and Rutland Clinical Commissioning Groups.  Mrs Reynolds confirmed that the Scrutiny Committee needed to be aware of issues raised by the Rutland community to ensure that the care services provided met the requirements of the local population.

The Chair stated that the Committee would examine the work plan to ensure that Rutland specific issues were addressed and that it would continue to monitor and scrutinise different aspects of the CCG’s work, as evidenced by items 9 and 10 on the agenda, as well as work in close collaboration with other stakeholders such as the Health and Wellbeing Board and Rutland Healthwatch to ensure that the voice of  residents was heard in such matters as community healthcare and integrated services.

Cllr Waller informed attendees that the Leicester, Leicestershire and Rutland Joint Health Committee of which she and the Chair were both members, had been and would continue to look at the various issues around reconfiguration.

Cllr Cross proposed a discussion regarding the deputation subject matter and was reminded that questions could be asked but a discussion  ...  view the full minutes text for item 4.

To consider any questions with notice from Members received in accordance with the provisions of Procedure Rule No.218 and No.218A.

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 219.

No notices of motions from Members had been received

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 call ins had been received

To appoint a Vice-Chair of the Adults and Health Scrutiny Committee.

The Chair requested nominations for the post of Vice-Chair of the Committee.  Cllr Cross nominated Cllr Waller, Cllr Harvey seconded the nomination and Cllr Waller accepted the nomination.  There were no other nominations received.

RESOLVED

a)    That Miss G Waller be APPOINTED as the Vice-Chairman of the Adults and Health Scrutiny Committee.

To receive a presentation on access to Primary Care Services.

The Chair confirmed that Mr Andy Rix from the Lincolnshire CCG had been unable to attend the meeting to answer concerns about Lakeside Healthcare in Stamford, which was one of the main practices for many of the residents living in the east of the county. However, he had offered to attend a meeting on another date. 

Cllr Harvey welcomed Rachna Vyas, Executive Director of Integration and Transformation for the LLR CCGs to the meeting.  The Committee received a presentation from Rachna Vyas on actions taken to improve access to Primary Care Services in Rutland and at Oakham Medical Practice.

The Chair thanked Rachna Vyas, Laura Norton and Dr Hilary Fox for the presentation and opened the meeting for discussion and questions. During the discussion, the following points were noted:

·         Local health and care services were available but had to be better advertised to Rutland residents.

·         Cllr Cross stated that complaints had been received from the public regarding GP services within Rutland and enquired about the training of GP receptionists.  Rachna Vyas confirmed that all GP receptionists were trained to identify treatments that required urgent and/or immediate treatment as well as those minor health ailments that could be signposted to other services.  Training was also given on safeguarding and care navigation.  Dr Fox confirmed that GP receptionists did not clinically triage patients but did allocate patients to the most suitable clinician which was not always the GP.  Members were also informed that GP receptionists had received verbal, racist and physical abuse from patients.  The Chair requested that Cllr Cross send details of the complaints from Rutland residents to Dr Hilary Fox for investigation.

·         Cllr Walters confirmed that Oakham Medical Practice was aware of the problems within the practice and that the Practice did have an improvement plan.  He confirmed that a recent presentation from the Practice had gone into greater detail and addressed the issues discussed.

·         Cllr Ainsley asked if the situation would improve and if so, in what time scale.  Rachna Vyas confirmed she expected incremental improvements and would discuss with Dr Pearson and Dr Fox the matter of patient satisfaction surveys at regular monthly intervals.

·         Dr Underwood reported that improvements had been made to Oakham Medical Practice but that patients were unaware of the improvements made so better communication was required.

·         Cllr Waller requested that information provided in the future be separated so that Rutland data could be analysed independently from that of Leicester and Leicestershire’s information.

·         Cllr Waller questioned how the integration of services would be funded, who identified what services would be sited locally and how the integration of services would be communicated to Rutland residents.   Rachna Vyas confirmed that there was a joint budget between RCC and the CCG called the Better Care Fund which funded the integrated care service.  Both organisations, along with the Primary Care Network, were united in their vision of care services to be provided within the county and work continued in integrating further services such as pharmacies, optometrists etc.  She confirmed  ...  view the full minutes text for item 9.

To receive Report No.80/2021 from the CCG Performance Service.

The Committee received Report No. 80/2021 from the CCG’s Performance Service. Councillors received information from Rachna Vyas who highlighted the most relevant and important points to discuss.  During the discussion, the following points were noted:

·         Dr Underwood enquired what was being done regarding non-attendance by patients to appointments.  Rachna Vyas confirmed that LLR used the messaging service to remind patients of their appointment and that LLR had one of the lowest non-attendance rates in the country but that each person who did not attend their appointment was contacted the same day and their appointment re-booked.

·         Rachna Vyas confirmed that the data referred to any person registered within Leicester, Leicestershire and Rutland who attended health services located inside and outside of the county.  Comparative data for external health services e.g. Peterborough City Hospital was not given as it was not LLR data but it could be requested.

RESOLVED:

a)    That the Committee NOTED the Rutland Health performance based on the available data.

b)    That updated health performance reports be PRESENTED quarterly at future meetings of the Adults and Health Scrutiny Committee to ensure ongoing improvements.

c)    That Rachna Vyas REQUESTED the comparative data for external health services e.g. Peterborough City Hospital and sent it to Cllr Harvey

d)    That Rachel Vyas CHECKED the definition of the term ‘hospital’ within the data and if it involved ‘urgent care services’ and sent it to Cllr Harvey

e)    That Rachel Vyas SENT Cllr Harvey updated health performance data as and when received plus data on the numbers of Rutland residents who accessed out of area health services.

To receive Report No.75/2021 from the Director for Adults and Health

The Committee received Report No. 75/2021 from the Strategic Director of Adults and Health. Councillors received information from Mr John Morley who highlighted the most relevant and important points to discuss.  During the discussion, the following points were noted:

·         Mr Morley reported that the figures stated on the report were pre-Covid and that Adult Services had changed considerably during the past 18 months with increased numbers and increased pressures.

·         During Covid, the service had seen a 13% increase in the number of complex cases;  a 39% increase in the number of homeless applications; a 150% increase in referrals to the Admiral Nurse service and a 135% increase in referrals to Occupational Therapists, who for the first time in 3 years, had a waiting list.  40 cases a month were referred to the Mi-care Team whilst the rate of keeping patients out of hospital was maintained at 91% or more.

·         Rachna Vyas thanked John Morley, Emma Jane Perkins, Kim Sorsky and Mat Wise for their assistance and support during the pandemic and confirmed that all services had worked extremely well together during the most difficult year ever.

·         Mr Morley introduced Kim Sorsky, Head of Adult Social Services who reported a significant rise in the number of complex cases that had required assessment.  An increased demand had resulted in an increased number of carers but these had been recruited at an overall reduced cost.  An online housing application system had also been trialled and tested and was now live on the Council’s website.

·         Mr Morley introduced Mat Wise, Hospital and Clinical Integration Lead who reported that the system for discharging patients from hospital had changed during the pandemic.  Previously the patient would be visited on the ward and a discharge assessment completed.  However, during the pandemic the patient would be discharged home (where possible) with the support and assistance of services for 2-3 days so that a detailed assessment could then be completed to determine the most appropriate pathway and this new system had worked very well with the co-operation of Emma Jane’s team.  Moving forward, the Occupational Therapy team would be working with Loughborough University to undertake analysis of the number of falls recorded within Rutland so to better target preventative resources.  It was also planned to increase the therapy service to cover weekends as it moved to a 7-day/week service.

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The Chair requested an extension of the meeting

The Committee voted to extend the meeting by 15 minutes

Andy Williams, Rachna Vyas, Laura Norton, Dr Hilary Fox and Fay Bayliss left the meeting at 20:26

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·         Mr Morley introduced Emma Jane Perkins, Head of Community Care Services who reported that the day opportunities service that supported adults with learning disabilities, had not been able to deliver all services during lockdown but staff had been re-deployed to support RISE and Mi-care services.  The service, in conjunction with the voluntary sector, had also contacted all patients leaving hospital care to ensure that they were well and safe. The Care Homes Clinical  ...  view the full minutes text for item 11.

To discuss substantive items for scrutiny and inclusion in the Adults and Health Scrutiny Committee work programme for the municipal year 2021-22.

The Committee received the annual work plan for discussion.  During the discussion, the following points were noted:

·         John Morley reported that the Rutland Health and Wellbeing Board was the main governance for the development of the Place Led Plan and its integration into the Health and Wellbeing Board’s strategy so that there would be one overarching plan.

·         A draft Place Led Plan (as it would be a very big piece of work) would be presented at the October meeting of the Rutland Health and Wellbeing Board. 

·         The Integrated Delivery Group (IDG) had been established to feed into the Rutland Health and Wellbeing Board and its members included various partners from RCC, the PCN, the CCG, NHS Trusts and Healthwatch. 

·         Three working groups (prevention, complexity and data) would report to the IDG and these consisted of the staff running the actual services involved.

·         The aim of the IDG would be to create a draft plan of what the integrated services would look like.

·         Integrated services must go live in April 2022 and that was the deadline.

RESOLVED:

a)    That an overview of the Place Led Plan be PRESENTED to the Adult and Health Scrutiny Committee on the 9^th September 2021 before the draft plan is presented to the Rutland Health and Wellbeing Board on the 5^th October 2021.

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

·         Cllr Harvey reported that the Care Quality Commission (CQC) were undertaking a questionnaire of patients’ experiences at Lakeside Healthcare Centre at Stamford and suggested that they present their findings at the next Scrutiny Committee Meeting.

·         Cllr Harvey informed attendees of the Members’ Briefing regarding the consultation on ‘Step Up to Great Mental Health’ which would be held on the 12^th July at 6 p.m.  Closing date for the consultation was the 15^th August 2021

https://www.greatmentalhealthllr.nhs.uk/

·         Dr Janet Underwood informed attendees of the monthly events run in conjunction with Healthwatch Leicester and Leicestershire.  This month’s event was ‘Access to GP Care’.  https://www.healthwatchrutland.co.uk

·         Cllr Harvey expressed thanks to the staff and volunteers at the Vaccination Centre in Oakham, which had one of the highest vaccination rates in the country. 

Thursday, 9 September 2021

Thursday, 9 September 2021 at 7.00 p.m. via Zoom