Agenda and minutes

Health and Wellbeing Overview and Scrutiny Committee
Thursday, 6th September, 2018 7.00 pm

Venue: Committee Room 1, Civic Offices, New Road, Grays, Essex, RM17 6SL. View directions

Contact: Jenny Shade, Senior Democratic Services Officer  Email: Direct.Democracy@thurrock.gov.uk

Items
No. Item

10.

Minutes pdf icon PDF 82 KB

To approve as a correct record the minutes of the Health and Wellbeing Overview and Scrutiny Committee meeting held on 14 June 2018.

Minutes:

The Minutes of the Health and Wellbeing Overview and Scrutiny Committee held on the 14 June 2018 were approved as a correct record.

11.

Urgent Items

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.

Minutes:

There were no items of urgent business.

12.

Declarations of Interests

Minutes:

No interests were declared.

13.

HealthWatch

Minutes:

Kim James stated the HealthWatch Annual Report had been tabled for Members information and asked that any questions be emailed to her for a response.

14.

Sustainability and Transformation Plan Consultation Outcome - Verbal Update

Minutes:

Tom Abell, Deputy Chief Executive and Chief Transformation Officer, Basildon & Thurrock Hospital Trusts, provided Members with an update on the STP Consultation Outcomes. On the 6 July 2018, the CCG Joint Committee supported the 19 recommendations within the decision making business case. The post decision scrutiny stage has now begun and the Joint Health and Wellbeing Overview and Scrutiny Committee met last week and will now focus on key issues such as transport, workforce and finances. That the People’s Panel had been set up by HealthWatch to review the services being moved from Orsett Hospital into the Integrated Medical Centres which would provide an independent voice on what changes would take place. Work would continue with the Clinical Commissioning Group and Thurrock Council and publicity on the changes to the services would be advertised and be posted on social media. Tom Abell stated Orsett Hospital would not close until services had been relocated. There would be a lot of work to be done over the next couple of years and would present regular updates to Members so that residents were assured that all services currently at Orsett would stay in Thurrock.

 

The Chair thanked Tom Abell for the update.

 

Councillor C Kent questioned who the members of the People’s Panel would be. Kim James stated the panel would not be overseen as part of the Sustainability and Transformation Plan or by the Clinical Commissioning Group but be made up of local people. These local people would be from patient groups, community groups, carers and residents who had an interest or currently used the services at Orsett Hospital. Kim James stated the first core group would take place on the 17 September 2018 where the terms of reference would need to be agreed and a chair and vice chair be appointed. A member of HealthWatch would be available to assist with the administration items and a web site and a Facebook page would be created to help engage with residents.

 

The Chair stated that as resident’s representatives Members should continually ask questions to reassure residents. The Chair asked how members and residents could get more involved. Kim James stated the People’s Panel would include regular users of services and engagement with residents would continue. With local community leaders representing groups and members of the public would be welcome to participate with HealthWatch monitoring the panel and provide necessary feedback.

 

Councillor C Kent asked how the transport links would work between each of the four Integrated Medical Centres. Tom Abell stated lots of work was being undertaken to improve the accessibility of the transport links between the Integrated Medical Centres and discussions had already taken place with bus companies.

 

Councillor C Kent asked for clarification on what services would remain in Orsett and not be transferred to Brentwood and Basildon. Tom Abell stated currently a third of the services were used by residents from Brentwood and Basildon and those would remain within those areas. Tom Abell stated different services would be delivered  ...  view the full minutes text for item 14.

15.

Establishment of a Task and Finish Group in Relation to Orsett Hospital pdf icon PDF 56 KB

Additional documents:

Minutes:

Roger Harris, Corporate Director of Adults, Housing and Health, presented the report following the expression from the Chair of Thurrock Health and Wellbeing Overview and Scrutiny Committee to establish a Task and Finish Group to review the future options for Orsett Hospital following the announcement that Orsett Hospital would close. Roger Harris referred Members to the Terms of Reference in Appendix 1.

 

The Chair stated this was an opportunity for Members to work closely with HealthWatch and the People’s Panel but to ensure that work would not be duplicated.

 

Jenny Shade, Senior Democratic Services Officer confirmed the next step would be for Democratic Services to contact Group Leaders to seek nominations to the Task and Finish Group.

 

RESOLVED

 

1.         That the Health and Wellbeing Overview and Scrutiny Committee agreed that a Task and Finish Group be established under the title of review of the future options for Orsett Hospital.

 

2.         That the Health and Wellbeing Overview and Scrutiny Committee agreed that the proposed terms of reference be adopted.

16.

Young Person's Misuse Treatment Service Re-Procurement pdf icon PDF 99 KB

Additional documents:

Minutes:

Kevin Malone, Public Health Manager, presented the report on the re-procurement of the Young Person’s Misuse Treatment Service. Members were informed that the current contract expires on the 31 March 2019 and following a full needs assessment of young person’s substance misuse in the borough had made the recommendations within the report.

 

An additional recommendation had been added to the report and will be included in the Agenda report being presented at Cabinet on the 12 September 2018. The additional recommendation read as follows:

 

“That the new contract has a duty built in to work with our own schools and expanded Youth Offending Service to tackle any drug or gang culture in Thurrock, and become a signatory to the new Compact to be written by the Corporate Director of Children’s Services outlining how YOS and the wider Council will work with schools to tackle drug and gang issues.”

 

Councillor Allen stated that the misuse of substances amongst children could affect mental health and questioned whether children would be seen by Thurrock Mind and what the current waiting times were. Kevin Malone stated the mental health services for children had been commissioned by Thurrock Children Services and that an assessment and referral would be undertaken in a couple of weeks. Kevin Malone stated that at this time the demand for this service (ie. the drug and alcohol service) for children was not high.

 

Councillor C Kent questioned what work was taking place with primary schools, teachers and carers on the importance of substance misuse. Kevin Malone stated that work was being undertaken at primary and secondary schools with prevention of misuse being vital with the drug market changing rapidly.

 

Ian Wake, Director of Public Health, stated the demand for services for adults was high and a further paper would be presented to the committee.

 

RESOLVED

 

1.         That the Health and Wellbeing Overview and Scrutiny Committee were appraised of and commented on the re-procurement of the Young Person’s Substance Misuse Treatment Service prior to Cabinet.

 

2.         That the new contract has a duty built in to work with our own schools and expanded Youth Offending Service to tackle any drug or gang culture in Thurrock, and become a signatory to the new Compact to be written by the Corporate Director of Children’s Services outlining how YOS and the wider Council will work with schools to tackle drug and gang issues.

 

3.         That the Health and Wellbeing Overview and Scrutiny Committee commented on the recommendations within the needs assessment.

 

Kevin Malone left the committee room at 7.50pm.

17.

Primary Care Strategy - Thurrock Clinical Commissioning Group pdf icon PDF 294 KB

Additional documents:

Minutes:

Rahul Chaudhari, Director of Primary Care, Thurrock Clinical Commissioning Group, presented the report which highlighted an existing and growing, demand and capacity gap for Primary Care Services within Thurrock with the Primary Care Strategy having the potential to regenerate and revitalise primary care locally reducing the workload of general practitioners and improve the service being offered to patients. Rahul Chaudhari stated the aim would be to make Mid and South Essex a place where medical staff want to come and work. Members were referred to the Appendix that outlined the strategies key themes.

 

The Chair thanked Rahul Chaudhari for the report.

 

Councillor Allen stated there was a shortage of general practitioners in the borough with 8 of the 36 under doctored posts being in Tilbury and questioned whether those figures were still correct. Rahul Chaudhari stated the picture was forever changing with the challenge that 25% of general practitioners are over 55 with the eldest being 82 but would confirm the figures and let Members know.

 

Councillor Redsell stated more should be done to encourage more general practitioners into Thurrock and questioned what action was being undertaken on missed appointments. Councillor Redsell also stated not all residents had access to digital equipment. Rahul Chaudhari stated it took 11 years to become a general practitioner and work was being undertaken with Anglia Ruskin University on future courses. That placement positions were being offered at general practices with the hope students would stay in Thurrock following their training. The redevelopment of the Integrated Medical Centres would offer services and entice new general practitioners. With open shows being undertaken to promote Thurrock and three general practitioners from the EU now worked in Stifford Clays and Grays. Rahul Chaudhari stated a quarter of daily appointments were being missed. With the introduction of the MS Text Service offering a 2-way reminder service, residents will be able to cancel by texting the practice. This service had been trialled in the South East and reduced the number of missed appointments by 25%. Raising awareness promotions were being undertaken in practices and in some practices 3-strikes and residents were being struck-off. Rahul Chaudhari stated the digital way forward was not to replace the existing service but to give residents another option to get in touch with their general practitioner.

 

Councillor Redsell praised the good work being undertaken by pharmacists in Thurrock.

 

Councillor Allen stated when general practitioners would be available at the new £20 million Integrated Medical Centre in Tilbury. Rahul Chaudhari stated primary care services through general practices would be available from day 1 of the opening.

 

The Chair stated a change in mind set of the workforce would need to be addressed and had there been any concerns with recruiting general practitioners internationally. Rahul Chaudhari stated people had concerns with Brexit and unsure how they would be treated. With direction expected from the Secretary of State shortly on special treatment for medical staff from the EU.

 

Councillor Rigby questioned whether the primary care services would cope  ...  view the full minutes text for item 17.

18.

Market Development Strategy - Commissioning a Diverse Market pdf icon PDF 70 KB

Additional documents:

Minutes:

Catherine Wilson, Strategic Lead Commissioning and Procurement, presented the report which stated a requirement that Adult Social Care published a Market Development Statement that would set out how Thurrock would see the social care market developed over the coming years. Catherine Wilson referred Members to the statistical data in the Appendix.

 

Councillor Redsell asked for clarification on the statement “40% of older people living in nursing/care services suffer depression. Older people in residential care are two to three times more likely to experience depression than other people in the community”. Catherine Wilson stated this statement was difficult to quantify but the reasons being that older people were depressed was because they were not living in their own home or with their own family and were lonely. Work would continue with the Wellbeing Team to ensure continued engagement was made within the community.

 

Councillor Redsell stated that more should be done with volunteering and with the interaction of children with older people.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee commented on the Market Development Strategy.

19.

Integrated Medical Centres : Delivering high quality health provision for Thurrock pdf icon PDF 101 KB

Additional documents:

Minutes:

Roger Harris, Corporate Director of Adults, Housing and Health, presented the report which updated Members on the progress made on all four Integrated Medical Centres with particular detail on the delivery of the Tilbury and Chadwell centre. The report would be presented to Cabinet on the 12 September 2018 to recommend that the Tilbury and Chadwell Integrated Medical Centre go out to tender. Roger Harris stated that the affordability tests were still to be carried out and planning applications would be submitted in the next few months.

 

The Chair noted that the Primary Care Model had been used in other areas and congratulated the team on the good work.

 

Councillor Redsell stated her concern with parking at the Thurrock Community Hospital when the Integrated Medical Centre was open. Camille James, Regeneration Programme Manager, assured Members that the increase in the parking requirements had been considered by the Highways and Planning and Regeneration Development Teams and would need to satisfy the needs of the Integrated Medical Centre.

 

The Chair stated that parking would depend on what services were at which Integrated Medical Centre. Camille James stated that parking would continue to be monitored but would depend on the number of staff, the services being offered and the turnover of services at each Integrated Medical Centre.

 

Roger Harris stated that parking had formed a major consideration in the planning of the Integrated Medical Centres.

 

Councillor C Kent questioned whether the building of the Purfleet Integrated Medical Centre was dependent on the Purfleet Regeneration going ahead on time.  Roger Harris stated that it had been made absolutely clear that the Purfleet Integrated Medical Centre would form part of the Phase 1 planning application.

 

Councillor C Kent asked about the transport links between Ockendon and Purfleet. Camille James stated that liaisons with local bus companies would take place prior to the Purfleet Integrated Medical Centre opening.

 

The Chair suggested that both the Health and Wellbeing and the Planning Transport and Regeneration Overview and Scrutiny Committees work together going forward.

 

Camille James stated that the same report would be presented at the Planning Transport and Regeneration Overview and Scrutiny Committee next week and asked Members to forward any further questions to democratic services.

 

Councillor Redsell encouraged more Members and residents to attend the Bus User Group so that existing bus services and views from residents could be incorporated into the proposals.

 

Councillor Allen questioned what the investment potential and the return of the invested £20 million into the Integrated Medical Centres would be. Roger Harris stated the decisions to build the Integrated Medical Centres would be for Cabinet to decide. The building infrastructures were being made to improve health care in the borough and not as a profit making scheme. The cost of the building would be recouped back by the rents paid by occupiers of the building.

 

The Chair questioned how confident that the four Integrated Medical Centres would be ready by 2021. Roger Harris stated that realistically the centres would likely be ready  ...  view the full minutes text for item 19.

20.

2017/18 Annual Complaints and Representations Report pdf icon PDF 64 KB

Additional documents:

Minutes:

Roger Harris, Corporate Director of Adults, Housing and Health, presented the report on the operation of the Adult Social Care Complaints Procurement covering the period 1 April 2017 to the 31 March 2018 and updated Members on the representations included in this statutory annual report. Roger Harris referred Members to the Appendix which summarised the representations received with the figures heading in the right direction with the most representations being made from home care services.

 

Councillor Redsell stated the detailed number of representations in the report did not match up with the total of 404 representations. Roger Harris agreed to check with the report author and update Members following the committee.

 

Councillor Rigby questioned the reasons for the number of complaints in the home care services. Roger Harris stated this was mainly missed calls due to carers being stuck in traffic or still with previous clients.

 

Roger Harris stated that this report had been taken very seriously and the Council had followed the statutory process.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee considered and noted the report.

21.

Mental Health Peer Review pdf icon PDF 69 KB

Additional documents:

Minutes:

Roger Harris, Corporate Director or Adults, Housing and Health, presented the report which summarised the findings and recommendations of the Peer Review of the wider health provisions in Thurrock that was undertaken in June 2018 as part of the wider mental health provision in Thurrock being reviewed. Concerns had been raised at previous Health and Wellbeing Overview and Scrutiny Committees on how hard it had been to access mental health services and HealthWatch raising concerns for residents with personality disorders. A report had already been presented at the Health and Wellbeing Board and will be presented to Cabinet in November 2018. Catherine Wilson, Strategic Lead Commissioning and Procurement, stated the review had been helpful and consideration that all the statutory duties were being carried out. Catherine Wilson thanked Thurrock Coalition and HealthWatch for their contributions.

 

The Chair thanked Officers for the fantastic review and stated that Mental Health was not just an issue in Thurrock but was a national concern.

 

Councillor Redsell stated that waiting times were too long and too much pressure had been put on schools and teachers. Roger Harris stated that Councillor Halden had chaired Thurrock's first Children and Young People's Mental Health Summit in June of this year. Work will continue with the Early Intervention Team to look closely at any gaps in the services and transition.

 

Ian Wake stated that half of adult health problems started in childhood and suggested that a report be brought back to the committee on the detailed assessments of children’s needs and demands.

 

Councillor Redsell stated there should be more of a presence in schools for young people to talk to.

 

Councillor C Kent stated that it was vital that young people had somewhere to go and someone to talk to who would not judge and provide the support required.

 

Ian Wake stated that as a high priority the learnings from the report would be used to ensure the user voice be strengthened and would report back to the committee on the proposed new themes to get young people into the system more quickly.

 

Councillor Allen echoed Members concerns and stated that early intervention was vital.

 

Councillor Rigby suggested a change of name to the term “Mental Health”. Ian Wake stated the term mental health seemed to be a stigma in today’s society and work was being undertaken with teachers for all young persons to try and address this issue.

 

The Chair referred Members to the national campaign “Time for Change”.

 

RESOLVED

 

That the Health and Wellbeing Overview and Scrutiny Committee commented on the findings of the Mental Health Peer Review.

22.

Work Programme pdf icon PDF 52 KB

Minutes:

The Chair asked Members if there were any items to be added or discussed for the work programme for the 2018-19 municipal year.

 

Members agreed that the Whole System’s Obesity Strategy report be added to the work programme for the 24 January 2019 committee.

 

Members agreed that the Thurrock Integrated Care Alliance be removed from 8 November 2018 committee and placed on the 24 January 2019 committee.

 

RESOLVED

 

1.         That the item Whole System’s Obesity Strategy be added to the 24 January 2019 committee.

 

2.         That the item Thurrock Integrated Care Alliance be added to the 24 January 2019 committee.