Agenda and minutes

Apologies for absence were received from Councillor Gemma New.  Councillor Edgar also gave apologies as he needed to leave the meeting at 11am as he had another engagement to attend later that morning.

Councillor Peter Edgar and Councillor Gwen Blackett both declared a non-prejudicial interest as they are both governors at Portsmouth Hospitals' NHS Trust.

 
It was RESOLVED that the minutes from the meeting held on 16 June 2015 be confirmed as a correct record subject to the following amendments:

Page 1 under the list of councillors present, Councillor Mike Read was the representative from Winchester City Council.

Page 1, minute number 1 should read 'Members asked that their thanks be passed on to David Horne for his great diligence and very conscientious work as Chair'

Page 1, minute number 4 - correction to the name and title of the person making the deputation which should be amended to 'Alan Burnett, Chair of Portsmouth Pensioners' Association'.  Mr Burnett had asked if a number of points be added to his record which he had raised at the last meeting but had not been included in the minutes. The panel agreed that Mr Burnett had made these points and that the below points be added to his deputation record. 

·        
The walk in centres were established by the then Government to widen access especially to those 'outside' the mainstream system eg. those visiting the city, homeless etc and not just to 'widen choice' cited in briefing note.

·         It is used by a wide range of patients in terms of ethnic background, age, residential location and need.

·         Mr Burnett urged the PCCG to extend the contract of the walk in centre and surgery at the present site  for two years, at least until the Government's plans for a more accessible primary care system is introduced. He felt that the Guildhall centre is in many ways a model of wider access which is envisaged which should be copied not closed.

The panel will consider the attached reports from:

Innes Richens, Chief Operating Officer, Portsmouth Clinical Commissioning Group

Paul Fisher, Minor Injuries Unit/ Minor Illnesses Unit Service Manager, Penny Daniels, Hospital Director and Dr Deb Jeavans-Fellowes, Operations Manager, St Mary's Walk In Centre.

The panel will also hear from Kim Dennis,  ...  view the full agenda text for item 4.

Innes Richens (Chief Operating Officer), Dr Hogan (Chief Clinical Officer) and Katie Hovenden, (Director of Professional and Clinical Development for NHS Portsmouth CCG) introduced their report which included the following points:

·         This was an update on the consultation and engagement which was due to end on 31 August and no decisions had been made on the future of Guildhall Walk Healthcare Centre (GHWHC).

·         The CCG had received support from Portsmouth City Council, Healthwatch Portsmouth University, PHT and Solent with promoting the survey.

·         The CCG is also working with the Portsmouth Pensioners Association, Portsmouth Disability Forum and the Carers Network to promote the online survey.

·         Focus groups are taking place with the Salvation Army.

·         An Equalities Impact Assessment is being finalised.

·         It was anticipated that a final decision on the CCG's preferred options will be made at the CCG board meeting on 23 September and the CCG will formally report these to the HOSP meeting on 18 September.  

Dr Janet Maxwell added that she had offered to support the CCG by asking her team to complete a needs assessment to understand the homeless population and their current access to healthcare.  Officers were working to ensure this was completed by early September.  This would include recommendations on future models of care.

In response to questions from the panel the following points were clarified:

·         Public transport to St Mary's Treatment Centre (STMC WIC) and parking were considerations in deciding whether to move the walk in service from GHWHC to STMC WIC.  The CCG were working with the council to consider options for improving public transport links.

·         With regard to the number of GP's retiring, Innes Richens advised that figures from the last local medical committee survey 18 months ago suggested that 39% of GP's plan to retire in the next 4-5 years.  This is around the same figure as for other parts of the country.  Dr Hogan added that because of this it was important to ensure not to be too dependent on GP's and look at other models of care.

·         All surgeries in the city offer same day access to appointments however some are more effective at allocating appointments the same day for patients than others.  The CCG are working with practices to find the best systems.

·         The GHWHC is under a contract with APMS which is provided by Portsmouth Health.  The cap on numbers felt like a pragmatic approach as the contract is due to end at the end of March.

·         The CCG have met with Portsmouth University recently.  There are 22,000 students registered at Portsmouth University and students have a choice on where they can register, with other surgeries such as the John Pounds Centre nearby to the university.  There are a number of practices in the city who have students registered at their practices. The age breakdown of patients at the GHWHC shows that a significant proportion of the patients are in the age range of students but it cannot be confirmed that they are students.

·         Dr Maxwell  ...  view the full minutes text for item 4.

Ursula Ward, Chief Executive Portsmouth Hospitals' NHS Trust will present the attached letter.

Ursula Ward, Chief Executive of Portsmouth Hospitals' NHS Trust introduced her report and added the following points:

·         There was a planned CQC inspection February 2015, which involved 60 inspectors over four days.  It was a very detailed process and they were vigorously assessed. The CQC's draft report was received in May which gave the hospital trust the opportunity to respond to any factual inaccuracies.  There were a number of misinterpretations and the CQC had accepted 75-80% of these changes.

·         The main reason for the overall rating of 'requires improvement' was due to unscheduled care, which was particularly busy during February when the inspection had taken place. 

·         PHT were very pleased to be rated outstanding on caring as only 4% of hospitals had received this rating so far. 75% of hospitals inspected had been rated as 'requires improvement' overall and 20-25% of hospitals had been put into the special measures bracket.

·         PHT received a follow up visit from the CQC on 25 April to view progress on improvements made to date and a report on this is expected in the next couple of weeks.  This will be circulated to the panel once received.

·         A number of improvements had already been implemented since February and during the next 6-12 months there would be another inspection.

·         A quality summit was held on 2 July which a number of partners, commissioners, the Trust Development Agency, Healthwatch etc. were invited to.  The quality improvement plan setting out the key themes and issues will be circulated for comment prior to submission to the CQC on 6 August.

·         The annual hospital open day is being held on Saturday 3 October which would give the opportunity to get behind the scenes which she encouraged the panel to attend if possible.  Some members said they were planning to attend this.

In response to questions the following points were clarified:

·         Attracting nursing staff is a big issue at PHT and also internationally. There are currently 300 unfilled nursing vacancies at PHT and they are recruiting nurses from Portugal and Spain to try to fill these.  Nurses training in Portugal in particular are of an incredibly high standard and the attrition rate is very low.  There is also a shortage of middle grade doctors with eight vacancies presently.

·         The practice of nursing is now more complex and there is evidence of young people wanting to get into nursing who do not want to go to university due to the large debt they will incur. PHT are trying to develop other roles based on experience of working with military staff who use medical assistants who carry out complex procedures and this has made a big difference.  They are also working on an education programme with Solent University to ensure good development programmes with a clear progression.

·         With regard to the impact on the ED once the 20,000 plus additional homes are built in the QAH catchment area, Ursula Ward said are all in the local health economy are recognising that a step  ...  view the full minutes text for item 5.

Carol Cleary, Interim Head of Services TQ2 will present the attached report.

Carol Cleary, Interim Head of Services TQ21 and Mark Stables, Service Manager introduced their report. In response to questions the following points were clarified:

·         TQ21 are working with Portsmouth and Hampshire Commissioners on the closure of the Tamerine Unit. 

·         The closure of Tamerine has brought forward the respite review.

·         The problem with Russets is that it is a large congregate setting with a multiplicity of functions and some people find this difficult.

·         An allocated Social Worker is meeting with all families individually to look at their needs and the needs of the person receiving respite care.

·         There are nine people who use Tamerine from Portsmouth City Council and 11 from Hampshire County Council.

·         Portsmouth is developing a small service for those who need it.  It will be part of a larger service to achieve economies of scale.  It is anticipated that it will be in place before the closure of Tamerine in December 2015.

·         TQ21 are in the process of transferring another short break service to Hampshire and there may be potential to use this service in the short term.

·         There is a general move away from residential care as it represents an inflexible and costly approach.  They are now looking to move towards a more personalised approach made possible by the development of a menu of options that will include outreach support and Shared Lives. This will provide a different offer that will have less emphasis on respite care.

·         Families and individuals using services will be consulted on change.

RESOLVED that the report be noted.

Carol Elliott, Head of Development and Patrick Fowler will answer questions on the attached report.

Carol Elliott, Head of Development and Patrick Fowler, Healthwatch Consultant introduced the report.  In response to questions the following points were clarified:

·         Healthwatch Portsmouth had suffered staff cuts and was now a team of three.  They are reliant on help from volunteers and currently have 10 volunteers who assist with running public surgeries to reach members of the public.

·         It had been challenging to get the Healthwatch Board established.

·         Healthwatch are an independent consumer's champion who can go into public places to get the public's views on different healthcare services they have received.

·         Funding cut of 30% from Portsmouth City Council for this year. Contracted until March 2016 and their funding is not ring fenced.

·         Councillor Ferrett said that Portsmouth City Council needs to ensure that Healthwatch are consulted when drawing up the next budget so they have the opportunity to raise any concerns. Carol Elliott said that she was already in talks with the contacts manager to see how the service can continue and would like to see an extension to the contract for stability.

·         The Panel felt that Healthwatch provide a great service and it was important they have enough funding to continue.

RESOLVED that the report be noted.