Agenda and minutes

At this point in the meeting, Members are asked to declare:

·        any personal interests not included on the Register of Interests

·        any prejudicial interests or

·        any disclosable pecuniary interests

which they may have in respect of business on this agenda.

Members were asked to declare any personal interests not included on the Register of Interests, any prejudicial interests or disclosable pecuniary interests which they might have in respect of business on the agenda.

In addition to the standing declarations of interest, Councillor Richardson declared a personal interest in relation to items on the agenda as a patient of York Hospital.

At this point in the meeting, members of the public who have registered their wish to speak regarding an item on the agenda or an issue within the Committee’s remit can do so. The deadline for registering is Tuesday 15 September 2015 at 5:00 pm.

Filming, Recording or Webcasting Meetings

Please note this meeting may be filmed and webcast and that includes any registered public speakers, who have given their permission.  This broadcast can be viewed at: http://www.york.gov.uk/webcasts.

Residents are welcome to photograph, film or record Councillors and Officers at all meetings open to the press and public. This includes the use of social media reporting, i.e. tweeting.  Anyone wishing to film, record or take photos at any public meeting should contact the Democracy Officer (whose contact details are at the foot of this agenda) in advance of the meeting.

The Council’s protocol on Webcasting, Filming & Recording of Meetings ensures that these practices are carried out in a manner both respectful to the conduct of the meeting and all those present. 

It can be viewed at: https://www.york.gov.uk/downloads/file/6453/protocol_for_webcasting_filming_and_recording_council_meetingspdf

It was reported that there had been no registrations to speak at the meeting under the Council’s Public Participation Scheme.

This report presents the Committee with the Annual Report of the Chief Executive of York Teaching Hospital NHS Foundation Trust, which details the performance and challenges faced by the hospital during the financial period 2014/15.

Members considered a paper that presented the Annual Report of the Chief Executive of York Teaching Hospital NHS Foundation Trust, detailing the performance and challenges faced by the hospital during the financial period 2014/15.

Members’ attention was drawn to the increased demand for services and efficiency targets.  Details were given of the trust’s financial performance, as detailed in the report.   The trust had reported its first ever deficit last year and a larger deficit was predicted for this financial year.

Discussion took place regarding the recruitment difficulties that were being experienced and the strategies that had been put in place to address this issue, including recruiting from overseas where necessary.  Members noted how the use of locum staff had impacted on the budget situation, although efforts were made to avoid using those private agencies which charged the highest rates.   At the request of Members, details were given of the implications of the registration system for nurses.  A team was being put in place to support employees in re-registering.

Members were informed that the vast majority of patients had a good experience of services.  The mortality rate also continued to fall.  The areas of challenge continued to be:

·        Emergency Department waiting times

·        The 18 week referral to cancer treatment targets

Members were informed of the actions that were being taken to address Emergency Department waiting times.  Staff continued to prioritise patients with greatest clinical need but it was a cause of concern that patients were attending the Emergency Department who should have been seen by their GP. One strategy that had been implemented was having GPs work in the Department and this had proved to be useful.

Clarification was sought as to the impact of delayed discharges.  Members were informed that consideration was being given to different models but this was an issue which the committee may wish to monitor.

Members asked about income generation by the Trust.  They were informed of the plans to maintain and develop elective services.  Members were informed that income from private patients accounted for only a very small amount of the trust’s income. 

It was noted that changing demographics were increasing pressures on services and hence there was a need to work differently.  Whilst hospital remained the most appropriate place for patients requiring acute care, many other services could best be delivered in the community.

Members were informed that the Care Quality Commission’s report following their inspection of the organisation would be reported to the committee at a future meeting.

Members asked about the nature of complaints that the hospital received.  They were informed that these were generally related to either clinical issues or staff attitude.  There were very few referrals to the Ombudsman.  Members were informed that future reports to the committee from HealthWatch would include comments from the Advocacy Service.

Resolved:  That the report be noted.

Reason:     To keep the Committee updated on the work of the Trust.

The Chief Executive of the Yorkshire Ambulance Service will present an Annual Report to the Committee.

Members received a presentation on the Annual Report of the Yorkshire Ambulance Service [a copy of the presentation is attached to the online agenda papers for the meeting].

Members noted that demand for emergency ambulances was increasing year on year, some of which was as a result of an ageing demographic. 

Details were given of the strategic priorities for the service and of A&E performance.  Explanations were given of the ambulance clinical quality indicators and of the measures that were being put in place, including employing additional staff and purchasing vehicles to address the issue of an ageing fleet.

Resolved:  That the report be noted.

Reason:     To ensure that Members are kept updated on the performance of this service.

This report is to inform the Health & Adult Social Care Policy & Scrutiny Committee of the performance of Yorkshire Ambulance Service NHS Trust in the judgement of the Care Quality Commission (CQC). The Yorkshire Ambulance Service NHS Trust Quality Report is at Annex A.

Members considered a report that detailed the performance of the Yorkshire Ambulance Service NHS Trust in the judgement of the Care Quality Commission (CQC). 

Members noted that the overall rating for the trust was “requires improvement” but that a “good” rating had been achieved in the judgements as to whether the services provided were caring.

Members’ attention was drawn to actions that the Trust must take to bring about the necessary improvements by:

·        Ensuring all ambulances and equipment are appropriately cleaned and infection control procedures followed

·        Ensuring that equipment and medical supplies are checked and are fit for purpose

·        Ensuring all staff are up to date with their mandatory training

A plan was in place to address the issues identified as requiring improvement and to ensure consistency across the service.  Members were informed of the actions that had already been taken, including the replacement of out of date consumables, improvements to deep cleaning and daily cleaning arrangements and new vehicle preparation procedures. 

Members questioned officers regarding the issues that had been raised.  They were informed that although procedures had been in place there had been inconsistency in how they had been applied across the Trust. 

Officers were asked about the action that was being taken in respect of staffing.  Members were informed that there had been quite a significant turnover in executive staffing but recent appointments had been made and there would now be more continuity.  The shortage of paramedics was a national issue and efforts were being made to recruit to these positions as well as developing career pathways to enable technicians and support staff to take on these roles.

At the request of Members, details were given of the opportunities and reporting systems that were in place to enable staff to give feedback and to report incidents.

Resolved:  That the Yorkshire Ambulance Service NHS Trust Quality Report be noted.

Reason:     To keep the Committee updated on the work of the Trust.

Members will receive a presentation on the transition of the Mental Health Learning Disabilities Services from Leeds and York Partnership NHS Foundation Trust to Tees, Esk and Wear Valleys NHS Foundation Trust.

A presentation was given on the transition of the Mental Health Learning Disabilities Service from Leeds and York Partnership NHS Foundation Trust to Tees, Esk and Wear Valleys NHS Foundation Trust [a copy of the presentation is included with the online agenda papers for this meeting].

The presentation included:

·        Information about Tees, Esk and Wear Valley NHS Foundation Trust, including its purpose, vision, goals, services and achievements.

·        The reasons why the Trust had tendered to provide services for the Vale of York and details of the five-year contract.

·        The way in which the Trust would be working with the voluntary sector.

·        The proposed structures.

·        The transition arrangements and the focus on providing continuity of care for patients and carers.

·        The immediate priorities.

The Chair drew Members’ attention to an email he had received from a member of the public regarding Bootham Park Hospital.  Members questioned officers about planned building work and were informed that the Trust was liaising with Leeds and York Partnership, NHS Property Services, the CCG and the voluntary sector regarding these issues.  Estate plans were being drawn up and it was hoped to put in place a robust plan for a new hospital as soon as possible.

Members sought clarification as to the role that would be played by Your Consortium.  They were informed that Your Consortium were used because of their experience in communicating and working with the voluntary sector and their knowledge and experience of funding routes and bespoke training packages.

Members sought clarification as to why services were being separated.  They were informed that physicians preferred the model that was being proposed and this aided recruitment.  There would, however, be flexibility across the boundaries.

Members asked about the risks during the transition.  They were informed that risk assessments had been carried out and that maintaining continuity of service was the key issue.

Officers were asked about the waiting list for counselling.  They were informed that the Trust first needed to understand what was already in place and to identify where recruitment was needed.  Initially the existing services would continue, including the use of independent counsellors.  Whilst it was preferable to deliver this type of service at GP practices if possible, there were limitations in terms of space and hence community bases may have to be considered.   Members noted that Lifeline, the existing provider, would continue to provide services for patients with drug or alcohol problems.

Officers confirmed that it was the intention to treat people locally wherever possible and within the Trust’s geographical area.

Resolved:  That the information on the transition of mental health learning disabilities services to Tees, Esk and Wear Valleys NHS Foundation Trust be noted.

Reason:     To ensure that the Committee is kept updated on the transition.

Members are asked to consider the Committee’s work plan for the municipal year.

Consideration was given to the Committee’s work plan for the remainder of the municipal year.

Members agreed that the following amendments be made to the work plan:

·        An item on Bootham Park Hospital to be included on the agenda for the October or November meeting (depending on officers’ availability to attend)

·        A member of York and District Pain Management Support Group to be invited to speak at the 20 October 2015 meeting.

·        An item on the York Teaching Hospital CQC Report to be included on the agenda for the meeting on 20 October 2015.

·        The six-monthly quality monitoring report – Residential, Nursing and Homecare Services be deferred from the October meeting to the November 2015 meeting.

Resolved:  That, subject to the agreed amendments, the Committee’s work plan for the remainder of the municipal year be approved.

Resolved:  To ensure that the Committee has a planned programme of work in place.