Councillors and committees
Agenda and minutes
In light of recent events and following the latest Government advice on the Coronavirus, the Council has cancelled all its scheduled council and committee meetings until 11th May 2020. At present the law does not permit local authorities to hold 'virtual' Committee meetings but the Council is committed to maintaining full transparency in the decision making process during this period and an update on how its governance will work will be provided shortly.
The Council will keep its arrangements under continual review, having regard to guidance as it emerges.
You can view the individual reports for this meeting by selecting the headings from the numbered list of items at the bottom of this page. Alternatively you can view the entire agenda by selecting 'Agenda Reports Pack' below.Watch key Council meetings here
Venue: Guildhall, Kingston upon Thames
Contact: Marian Morrison 020 8547 4623 e.mail: firstname.lastname@example.org
Apologies for Absence
Apologies for absence were received from Councillor Tim Dennen, Sarah Tedford, Deputy Chief Executive Kingston Hospital, Dr Emma Whicher, Medical Director, South West London and St George’s Mental Health Trust and Bethan Clarke, Service Development Officer, Learning Disability Service.
Declarations of Interest
Councillor Mary Heathcote declared a Personal Interest in agenda item 6, Thomas Pocklington Trust’s Vision Strategy for Kingston as she chaired the committee which was responsible for the Action Plan.
Agreed that: the Minutes of the meeting held on 14 January 2014 are confirmed as a correct record.
Members of the Learning Disability Parliament will talk about new developments
The report provided the Panel with an update on the work of the Learning Disability Parliament and the plans for the Parliament going forward. It also detailed the outcome of the recent review of learning disability provider services and the procurement process to transfer the Woodbury Residential Care and Respite Services and the Kingston Supported Living Service plus the work activities and transport service to Balance CIC, part of the Pure Group, a social enterprise. Current staff will transfer under TUPE arrangements. The provisional date of transfer is from June 2014.
Members also received a presentation about the work of the Learning Disability Parliament from two MPs, Katy Bessent and Greg Rata. They spoke about the wide range of initiatives which have been undertaken during the course of the current Parliament. These included:
· Obtaining people’s views about services received including from the police, transport, paid support
· Passing on views of people with learning disabilities eg about benefits, health, “Hate” and “Mate” crime, employment
· Raising awareness in schools
· Open meetings which are topic related
· Checking Access issues eg at Kingston Hospital which led to a new public lift for all wheelchairs and fully accessible toilet
· Launch of the “Safe Places” and “keep safe card” Initiative in Libraries, shops and restaurants across Kingston
· Two events on relationships and support
· Meeting with Normal Lamb MP about the Parliament and its achievements
· Agenda setting and organisation of the Learning Disability Partnership Board
Going forward there will be:
· Paid roles within the Parliament
· Greater liaison with project workers and HealthWatch Kingston
· Feed back to managers and commissioners about quality of services and support
The Panel thanked Katy and Greg for their presentation and wished them well with the future of the Parliament
Agreed that: the report is noted
Elizabeth Brandill-Pepper, Joint Children’s Health Commissioner and Simon James, Strategic Head of Special Educational Needs and Disability, will present this item
The purpose of the report was to explain the development of the Children’s Autism Strategy and how this links with the Adult Strategy for Autism.
A written question was taken during this item as it related to Autism
A presentation was given about the draft strategy and how this relates the Children’s and Families bill which received Royal assent this week and comes into force on 1 September 2014. This legislation has a considerable focus on transition from children’s to adults’ services which is being extended to cover 19-25 year olds rather than the previously defined cut off at age 18 which in some cases led to a loss of services as people move into adulthood.
The strategy for adults is a statutory process but because the prevalence of autism in Kingston is increasing in Kingston this warrants its own strategy which sits within the wider SEN Strategy and other Disability work across the borough. Prevalence in Kingston is 1.3% (this includes both statemented and non-statemented children) and is slightly higher than the national average of 1%. There are currently over 1000 children in Kingston with statements and service provision across health social care and education is good. Going forward there will be a strategic emphasis on in-borough provision rather than out-borough which are more expensive and involves travel time which is not ideal.
Whilst there has been a history of waiting list for appointments with some families waiting 4-5 years for diagnosis, this has now been eradicated and there is confidence that there will be no recurrence. Progress has been assisted by workforce stability and efficient reconfiguration of professionals involved using time cost analysis to achieve the changes within current budgets. This approach is being used elsewhere.
The draft strategy will be presented to the Joint SEN Strategy Group (Kingston and Richmond). The strategy includes arrangements for the cohort of children who currently do not meet the diagnostic criteria whereas previously support only followed statementing. The strategy is being developed in partnership with young people, parents, stakeholders and schools.
The Children’s and Families Bill is a large set of reforms for families and young people bringing together major priorities across health, social care and education and Kingston and Richmond has been identified as a good exemplar of early work in this area by the DfE and Edward Timpson MP.
The legislation is about increasing parental choice (initially identified in work undertaken by David Cameron). Currently outcomes are still poor compared to their peers and it is therefore important to support young people going into adulthood in order to help them achieve their potential.
The current statutory assessment process is long (26 weeks) and “siloed” in approach and Simon James referred to one parent who has 17 professionals working with his daughter and there is no lead. The new assessment process will be much faster and take place where the child is and will result in an individual Education Health and Care Plan. The Plan will be on line and ... view the full minutes text for item 68.
The Trust provided a written report which updated on the Foundation Trust Application. As part of the application process the Trust has developed a robust long term plan to service the mental health needs of the population in South West London and the plan has been assessed by the National Trust Development Authority (NTDA), KPMG, PwC and Cap Geminii. A recent FT Readiness Assessment has identified that the Trust is now ready to move to the final part of the NTDA Application stage assuming positive outcomes from the Chief Inspector of Hospitals’ inspection visit in March. The report listed the advantages of obtaining Foundation Trust Status including greater freedoms for reinvesting in the Trust services and buildings and flexibility to develop partnerships with other organisations and Trusts.
David Bullivent, recently appointed interim Service Director for Kingston and Richmond outlined the next steps related to the FT application. A board to board meeting between the Trust and the NTDA board will take place in June. This should proceed to assessment to Monitor in late summer. Governors elections for the Trust Council commence in April and a number of partner appointed governors will be appointed alongside elected Governors.
Other local developments included the successful integration of the assertive outreach team into main Teams and continuing to review the quality of these services. A new permanent consultant for has been appointed for Lilacs ward and a recent visit to Azaleas Ward by commissioners was very successful. The Child Adolescent Mental Health Services team (CAMHS) is developing the Children’s IAPTS. Reviews are taking place on services for older adults including dementia services which are being led by the CCG.
There has also been training with local police on managing mental health clients. The Trust is finalising S75 agreements with Social Care which will provide a robust framework for the future.
In response to questions from the Panel David Bullivent agreed to provide an answer about whether LA Councillors can be elected to the Council of Governors and about how young carers are involved in the planning of emergency care. He confirmed that the Trust has strong engagement with carers but would find out specific details in relation to young carers.
Agreed that: the report is noted.
Update from Kingston Clinical Commissioning Group
Tonia Michaelides reported on the current work of the CCG, now one year old, on the following three areas:
Better Care Fund - this is a DH initiative around integration of health and social care and will involve a significant shift of support away from Hospitals in 2014/15, including Kingston Hospital. The CCG is working with providers to see how this process can be managed. As part of the work, the CCG has gone through an assurance process and the Kingston’s outcome was the best possible. There have been several workshops bringing together partner organisations to consider how to bring integrated care to Kingston. One of the approaches is to form multidisciplinary provider teams to work together to provide integrated care for our most vulnerable people A Risk Stratification tool being used to identify people who would benefit from integrated care and this approach is being piloted in Holmwood and Churchill medical practices.
The final proposals will be presented to the next meeting of the Health and Well Being Board.
Integrated Operating Plan with adult social care will be going to a future meeting of the Health and wellbeing board.
Five year plan – this is the successor to the Better Services Better Value Programme (BSBV). Whilst this is a new piece of work, the case for change to meet required quality standards and financial challenges has not changed and the six SWL CCGs are working together to produce the South West London Collaborative Commissioning Strategy. The remit has moved away from the previous focus on acute hospital reconfiguration and there are new workstreams on mental health and primary care in addition to the planned care, maternity and urgent care covered by BSBV. There will be a presentation to the Health and Wellbeing. The final plan has to be submitted by 20 June.
Agreed that: the update is noted
Keith Valentine, Director of Empowerment at the Trust will present on this item
The Thomas Pocklington Trust gave a presentation to the Panel on 24 January 2013 outlining the UK Vision Strategy which has three key aims: to improve eye health in the UK, to prevent avoidable blindness and to ensure excellent support services enabling independence and social inclusion. Over the past year the Trust has undertaken work to enable this Strategy to be introduced locally in Kingston. The report and presentation provided an update on the progress with the strategy and the actions going forward.
Keith Valentine stated that the Trust is on of the few endowed charities and can therefore act neutrally and has no need to look for grants or contracts to support actions. It enables a process of bringing together key stakeholders to look at care pathways and the broader issues that visually impaired people (VIPs) confront in normal day to day activities.
Working with Mr Sharafat at the REU and Cllr Mary Heathcote the Trust has worked to develop the detailed work plan which comprises three key strategic projects. Michelle Baxter Wickham has been appointed by the Trust to work locally in Kingston. Key objectives include:
· Modelling a VIP Parliament on the Learning Disability Parliament
· Increasing Support available at the point of diagnosis in the REU - this will include the development of a volunteer programme to assist with the support that is needed
· Reducing Unemployment amongst VIPs – currently unemployment rates amongst VIPs is around 70%
Keith Valentine particularly thanked Cllr Heathcote for the considerable work she has put into this project.
In response to a question from the Panel, Keith Valentine confirmed that prevention of sight loss is very important and the Local Optical Committee (LOC) is working actively on this areas. 70-90% of sight loss can be prevented if caught in time. The action plan includes an objective of promoting attendance at opticians and this will be progressed over the coming year.
The Chair referred to the energy provided by the Pocklington Trust in relation to this work. Michelle Baxter Wickham who took up her appointment on Monday reported that she had already arranged meetings with key people, including Kingston Hospital and the Pocklington Trust has good contacts to enable engagement of volunteers and achieve the targets set out in the action plan.
1. The progress made to date including the formation of the Visually Impaired Parliament is endorsed by the Panel; and
2. a further annual report to update on progress made in the coming year is presented to the Panel in March 2015.
Cllr Heathcote declared a personal interest in this item as she chaired the committee which was responsible for the Action Plan.
This report sets out the work of the Sub Group appointed by the Panel on 18 September 2013 and the recommendations.
The Chair introduced the report. At the Health Overview Panel meeting on 18 September 2013 a Sub Group was appointed to consider the accessibility concerns raised by the Access Group about Surbiton Health Centre. The Sub Group met on four occasions, undertook a visit to the Centre and met with representatives of three health bodies: Your Healthcare, South West London Partnerships and Community Health Partnerships who have responsibilities for various aspects of the building.
The Sub Group also had input from Theo Harris from Kingston Centre for Independent Living, Carol Barnshaw, Kingston Association for the Blind and Fran Rogers a wheelchair user who put forward the disability perspective to health colleagues.
The full list of recommendations was appended at Annex 1 to the report. Agreement of relevant Health Bodies has been secured on most of the recommendations and procedural recommendations have also been made to ensure that disability issues are raised appropriately as part of the planning process (and pre-planning process) for both public buildings and major highways projects.
Whilst health organisations had not agreed to all of the recommendations, significant advances have been made around doors, lifts, proposals for dropped kerbs and the placement of a bollard to prevent car access. The Sub Group particularly welcomed the appointment of a Facilities Manager at the Centre which is seen as helpful both for access and in relation to the concerns previously raised in relation to the needle exchange petition.
The Chair pursued two specific recommendations and secured agreement to keeping the number of available hoists under review and adjusting the height of signage in the main entrance so that it is more obvious to wheelchair users.
1. the report is noted; and
2. a referral is made to the People’s Services Committee for consideration of the best way of ensuring disabled people are involved in planning.
The Strategy will be introduced by Lisa Cheek, Deputy Director of Nursing
Dr Jane Wilson, Medical Director, gave a presentation on the Kingston Hospital Dementia Strategy which was recently approved by the Trust Board. Nearly half of patients aged over 75 at Kingston Hospital either have dementia or receive a diagnosis of dementia during their stay. The high level is due to Kingston having one of the highest life expectancies in the country. This has led to the need to develop a strategy which deals more effectively with the needs of this group of patients whilst in hospital and to ensure their experience of care is the best possible. The strategy described many initiatives which are already in place including the Forget-Me-Not Scheme on wards which identifies people with dementia and the introduction of a Psychiatric Liaison service for older adults.
Dr Wilson explained that the Strategy is based on best practice and a dementia conference was held during its development which included 200 experts, clinicians, carers and others.
The Strategy also identifies approaches and actions around the following areas including meeting the Prime Minister’s Challenge on Dementia:
· Positive relationships of care – provided by staff who are confident in this area
· Early Diagnosis, excellent clinical treatment and care – especially for people who come in for other conditions
· Involved and supported carers – changing visiting hours is one action which has helped plus the development of a carers’ hub
· Encouraging active days and calm nights – the Trust employs a full time activity co-ordinator to encourage social engagement and memory boxes have been introduced on wards enabling meaningful conversations
· Environments of care – coloured doors and improved signage.
In response to questions raised by the Panel, Simon Pearce confirmed that skill level of paid carers in the community was an area which was being progressed. Engaging with the trust to help with training could be a good way forward.
Dr Martin Humphrey explained that people with dementia are at a higher risk of developing other co-morbidities, particularly of a psychiatric nature. The Psychiatric Liaison doctor role has been expanded to five sessions but this pilot ends in August 2014. The mental health trust is a key partner in the community managing a range of problems. It also has a memory clinic and assists with challenging behaviour which can be present with dementia.
Grahame Snelling welcomed the strategy on behalf of members of Healthwatch but queried the absence of detail about arrangements for discharge and liaison with the community. Dr Wilson explained that there were other workstreams dealing with this area and this strategy was aimed primarily at experience in hospital.
Councillor Julie Pickering (in the gallery) commended the strategy and thanked the hospital for spearheading this approach. However, Councillor Pickering drew attention to the need to pull together the various threads in the community and requested the Panel to consider this question. She requested a commonality of approach across the caring agencies and care homes. In response Simon Pearce referred to an analysis of the topography of current services i.e. establishing ... view the full minutes text for item 73.
· Outcomes of the KCCG publicity campaign about use of A&E
· Staff checks at Kingston Hospital
Staff checks at Kingston Hospital – this followed adverse publicity concerning the appointment of a locum. Dr Wilson confirmed that procedures for such appointments had been tightened up and that she sits in on the appointment of Locums. The case had involved poor trauma surgery outcomes. Dr Wilson confirmed that staff are encouraged to report poor practice.
Outcomes of the Kingston Clinical Commissioning Group’s publicity campaign about the use of A&E – this was not discussed.
The Deputy Chief Executive submitted a detailed report to the panel which covered the following topics:
· Better Care Fund – this new approach to support development of integrated care will present a risk impact on the Trust
· New SWL Pathology covering Kingston, Croydon and St George’s from 1 April 2014
· CQC 2013 Survey of Women – mums rated Kingston Hospital services as the best in London and among the top 20% in the country.
· Budget Setting and Cost Improvement programme – in order to achieve the required level of surplus (£2.3M in 2014/15) a cost improvement programme of between 6% and 7% is required and this is broadly similar to last year
· Patient Administration system – progress is being made on rolling out clinical documentation in A&E and e-prescribing
· Service Line Management – this involved an 18 month period of management and strategic planning development within service areas together with an accreditation system for individual service lines
· Winter Planning – Whilst the number of A&E attendances were slightly lower than December 2013 the number of very sick patients remained the same. 72 additional beds were used at the peak of activity. The trust was successful in obtaining additional winter pressure funding to increase staffing at weekends in pharmacy, phlebotomy and therapies.
Agreed that: the report is noted.
Agreed that: the minutes of the Health and Wellbeing Board meeting held on 4 February 2014 are noted.
The June 2014 meeting will be introductory for the new four year term but will include some business items eg South West London and St George’s Mental Health Trust Estate Proposals.
The work programme would be formulated in more detail following the May Local Elections and the first meeting of the new term (Tuesday 24 June 2014) would be of an introductory nature but include a limited number of business items.