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 email: firstname.lastname@example.org
Three questions were asked by Mrs Tarleton-Hodgson concerning Fuchsias Ward at Tolworth Hospital. These are summarised in the Annex to the minutes, which does not form part of the minutes of the meeting.
Apologies for Absence
Apologies were received from Grahame Snelling, Chair, Healthwatch Kingston.
Declarations of Interest
There were no declarations of interest.
The Minutes of the meeting held on 20 March 2014 are confirmed as a correct record.
To approve the continuation of the Advisory Members for 2014/15
· Grahame Snelling, Chair, Kingston HealthWatch
· Patricia Turner, Kingston Voluntary Action
Grahame Snelling, Chair of Healthwatch Kingston and Patricia Turner, Kingston Voluntary Action are re-appointed as Advisory Members for the 2014/15 Municipal Year.
The annual report outlines the progress and achievements made during the previous year.
The Annual Report of the Health Overview Panel for 2013/14 described the past year’s work. Some of the highlights included:
· Accessibility issues at Surbiton Health Centre
· Consideration of the petition to Council about Needle Exchange Services at Surbiton Health Centre
· Presentations – including Kingston Hospital’s Dementia Strategy, Kingston Vision Strategy, progress with Autism Strategies, Mental Health Crisis planning
· Exploration of topical issues such as hospital mortality rates, preparing for winter
Agreed that: the report is noted
To recommend the formation of the SJHOSC and nominate representatives
With the agreement of Chief Executives of the relevant London Boroughs a Standing Joint Health Overview and Scrutiny Committee is being formed to respond to health consultations about significant changes in health provision where these affect more than one local authority area. The participating LBs are: Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth. The first meeting will take place on 17 July 2014.
The following appointments to the SJHOSC are proposed for endorsement by Council on 15 July 2014:
Dr Jonathan Hildebrand, Director of Public Health will give a brief presentation on the role of Public Health in Kingston
Dr Jonathan Hildebrand, Director of Public Health gave a presentation on Public Health which included the prescribed and non-prescribed services, the funding mechanism, other key responsibilities and performance.
Public Health was sited in Local Authorities (LAs) until 1974 when it transferred to the NHS and in 2013 it returned to LAs. The Director of Public Health is a Chief Officer of the Local Authority and responsibilities are:
· responsible for the LA’s duties to take steps to improve the health of the people in its area
· to be on the local Health and Wellbeing Board
· to produce an Annual Report on the health of local people (the 2013 report was on older people and 2014 report will be on mental health)
· co-producing the Joint Strategic Needs Assessment with the CCG
which analyses the health needs and assets of the Kingston population and guides the commissioning of health, wellbeing and social care services, and underpins the Joint Health and Wellbeing Strategy, the production of which is one of the key responsibilities of the Health and Wellbeing Board.
LAs are required to provide the following elements of Public Health:
· Open access sexual health services
· Contraceptive services
· NHS Health Check programme
· LA role in health protection
· Public Health advice to Clinical Commissioning Groups
· National Child Measurement Programme
LAs also need to have to have regard to the Public Health Outcomes Framework and consider the evidence for these functions:
· Health improvement functions including smoking cessation, physical activity and obesity prevention services, mental health promotion
· Health services including substance misuse & alcohol treatment services and school health services
· Miscellaneous activities including action on social exclusion and the wider determinants of health
Public Health funding is passed from the Department of Health to Public Health England who transfer a proportion to LAs. The national budget is £2,794M. Kingston receives £9.302M and this is ring fenced until March 2016. Key budget elements are:
· £3.17M sexual health
· £1.49M substance misuse and alcohol
· £1.12M PH commissioning staff including CCG support
· £0.90M School health service
· £0.66M Physical activity and obesity prevention
Key public health performance in Kingston:
· Life expectancy for women is 84.5 years, 1.6 years more than the England average
For men the figures are 81.1 and 2.2 years
· Children living in relative poverty – 13.8% compared with national level of 20.1%
· Childhood obesity - 6.1% in reception year rising to 17.0% by year 6 compared with 9.3% and 18.9% nationally
· Percentage of people smoking - 15.1%, compared with 19.5% nationally. 706 quitters locally in 2013/14
· Alcohol related admissions to hospital – 386 per 100,000 population, compared with 637 nationally and Kingston has the lowest rate in London
· NHS Health Checks: 18.2% of the eligible population received a health check in 2013/14. Highest in London and fifth highest nationally
In response to questions from members Dr Hildebrand gave the following responses:
· There could be volatility in the budget for sexual health services as the demand can vary. Any additional costs would impact on other areas of the public health budget. ... view the full minutes text for item 7.
Simon Pearce, Executive Head of Adult Care will give a brief presentation on Adult Social Care
Simon Pearce, Executive Head of Adult Care outlined the current services:
Key Kingston population statistics and types of service:
22,000 people 65+ and about 10,000 75+
In 2013/14 Kingston Adult Social Care (ASC) offered support to 2771 people.
500 people in residential or nursing home care.
1100 nursing and residential places in Kingston and the Council uses around 300 of these.
800 people receive Home Care over a year and over 600 receive this weekly
600 receive adaptations
450 people with Learning Disability are supported: 44 residential in Borough, 68 residential out of Borough, 204 in supported living, 130 living with family and 4 in Adult Placements.
Layout of Council Services:
The Council Contact Centre is the first point of contact for any enquiries and offers signposting and information. They also assist with concessionary fares and Blue Badge work.
People who need more help access services via the following routes:
· Learning Disabilities - via the Joint Team (with NHS) at Sessions House
· Mental Health - via GPs and South West London and St George’s MH Trust. Substance Misuse services are provided via the dedicated joint team
· Primary Care Mental Health Service - via GPs and a dedicated Team
· Everyone else: Older People, Physical Disabilities, sensory impairment, Hospital discharge etc - via the Short Term Team in GH and Kingston Hospital.
· Longer term work is done via teams co-located with NHS colleagues: Two Long Term Older People and Physical Disabilities Teams, a joint Older People’s Mental Health Team, a Learning Disabilities Team, Sensory Impairment Team, two working age adult Mental Health Teams, an Occupational therapy Team and a joint re-ablement team.
· The Council runs two residential/nursing homes for older people: Hobkirk House and Murray House
· There is a dedicated Safeguarding and Mental Capacity Act Team (SAMCAT)
Partners and Providers:
· Learning disability provider services, including Woodbury (a 14 bed residential home), Day activities (including the farm), work activities and supported living transferred to the Social Enterprise “Balance” on 1 July 2014.
· Mental Health Services are provided in partnership with South West London and St George’s Mental Health Trust.
· The Primary Care Mental Health service, ie the Wellbeing Service, is provided by Camden and Islington NHS Foundation Trust.
· The Substance Misuse Service is provided in partnership with City and Westminster Mental Health NHS Trust.
· There is extensive partnership with “Your Healthcare”. Social work teams are co-located with them and they provide an integrated Intermediate Care and Re-ablement service which includes Amy Woodgate House, a home for people with dementia type illnesses. The Kingston at Home Contract value is £4.547m
· There are over 50 registered residential and nursing homes in Kingston, providing over 1100 beds and Kingston is a net importer of people into these beds.
· In 2013 RBK made arrangements with three Home Care suppliers: Alpenbest, Eleanor Home care and Caremark.
· There are extensive partnerships with the Third Sector: Age Concern, Kingston MENCAP, MILAAP, Alfriston, Kingston Carers Network, KCIL and the churches.
Regulation and statutory monitoring:
Providers are registered ... view the full minutes text for item 8.
· Kingston Hospital NHS foundation Trust – Sarah Tedford, Deputy Chief Executive
· South West London and St Georges Mental Health Trust – Dr Emma Whicher, Medical Director
· Kingston Clinical Commissioning Group - Tonia Michaelides, Interim Chief Officer
Kingston Hospital NHS Foundation Trust: Sarah Tedford gave an overview of the Trust.
Kingston Hospital is a single site district general hospital covering a local population of 320,000. It has an annual turnover of £200M and employs 2700 staff. Core services are Elective and Acute services, which include planned surgery, day case and outpatients and it has a large Accident and Emergency with an annual A&E attendance of 110K patients per year. Maternity services are considered to be the best in London and there are 6,000 births per annum.
The Trust is continuing to develop relationships with GPs and increasingly care is being provided in community with consultant outreach – particularly at Raynes Park and Surbiton Health Centre. It works closely with Royal Marsden who are partners in the Sir William Rouse Unit where the Royal Marsden provides chemotherapy. There are also close links with St George’s Hospital and South West London and St George’s Mental Health Trust. Private facilities are offered on the 7th floor of the Coombe Wing.
The Trust has consistently performance well against national targets and its financial position is good. It has each year delivered the required surplus together with £10m savings for reinvestment in services. Estate issues will be covered elsewhere on the agenda
Frail elderly: Further refinement of discharge arrangements is underway. In the case of frail elderly patients, initial discharge will be to an appropriate setting for a fuller assessment before final placement is agreed.
The Dementia Strategy discussed at the March Panel meeting has reviewed model of care for this group of patients. The older patient group, many who are aged over 90, require a longer length of stay than younger patients.
The IMT strategy is key to improving patient care and this will enable more effective systems for clinical documentation and e-prescribing.
There are still some administrative problems for both patients and GPs and processes are being improved.
External changes eg the South West London review of services will impact on the Trust and the Trust is participating in the review. In terms of other financial challenges the Trust is well placed currently, but this could change in the future.
The following responses were made to members’ questions:
· The Trust currently has significant nursing vacancies and also in sonography and other clinical areas. To meet some vacancies the Trust is training its own staff eg for radiology. Student nurses will be joining in September and attempts are being made to recruit 50 nurses in Spain and Portugal. The team ensures that nurses have good level of English language and further help with language and accommodation is offered to ensure new staff fit in well.
· Record sharing between hospitals – currently if the patient is transferred to a different hospital then notes would go with the patient. If following discharge a patient attends an alternative hospital, then there would be no records access for the second provider.
· Patient information systems are updated to show that patients who ... view the full minutes text for item 9.
Sarah Tedford, Deputy Chef Executive, will outline the Trust’s Estates Strategy
Sarah Tedford gave a detailed presentation on Kingston Hospital’s Estate Strategy. KHT currently budgets £3M per year on estates. However, the cost to bring the entire site up to standard is £30M of which £14M is required for critical site wide infrastructure work i.e. steam, ventilation, heating, electrical etc. The current annual budget will support the cost of these critical projects over a five year period.
However a further £16M is required for new capital funding projects including windows replacement in Esher block, office and nurses accommodation, A&E and outpatient areas, especially to improve patient navigation. The rationale for these includes safety and patient experience plus implementation of strategies such as the Dementia strategy. None of these costs are for service developments such as expansion of maternity services.
Detailed business cases have been drawn up for each scheme and a submission has been made to the Foundation Trust Funding Facility for a £10m loan to be re-paid over 15 years. A significant legacy will enable the addition of a third floor on the William Rouse Cancer Unit. Car parking changes – payment on exit will be in place in September.
In response to questions from members Ms Tedford provided the following information:
· The command centre is unsafe and therefore needs to be demolished
· There are no plans to increase car parking charges, but the changes to payment on exit will be much better for patients and visitors. Unfortunately further improvements to car parking capacity by adding an additional floor to the multistorey car park would be costly and RBK Planners wish to maintain the current skyline.
1. The trust would to advise the Panel on interest rates for capital project; and
2. The Panel welcomed the introduction of the new pay on exit arrangements for car parking and endorsed the work of the William Rouse Unit.
To consider the work programme for future meetings.
Members identified a number of areas which could be considered for inclusion in the work programme for forthcoming meetings. These included:
· Sexual Health Budget
· Childhood Obesity
· Maternity Services as cross the borough
· Child and Autism Strategy follow up
· Adult Autism Strategy
· Transport links from South of the Borough to health service providers especially the two hospitals serving the area and Surbiton Health Centre
1. The Chair and Vice Chair in conjunction with Democratic Support to agree the work programme for future meetings taking on board the comments made by members; and
2. A GP advisory member be identified.
To consider the minutes of the last meeting and whether or not under its scrutiny powers the Panel needs to consider any of the items in more detail at a future meeting
Agreed that: the minutes are noted.