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
Former Councillor Frank Thompson
The Chair drew attention to the sad news concerning two former Councillors Frank Thompson and Chrissie Hitchcock who passed away at the end of May. The funerals took place on Monday 8 June 2015. Frank Thompson had been a member of this Panel and he retired from the Council due to ill health in September 2014. The Chair was sure that he would be missed by all sides of the Council and that the Panel would wished to pass on condolences to Mr Thompson’s family. The Chair also wished to remember former Councillor Chrissie Hitchcock, although she was not a member of this Panel.
Apologies for Absence
Apologies for absence were received from Councillor Linsey Cottington and Councillor Shiraz Mirza. Councillor Sheila Griffin attended as substitute for Councillor Cottington.
Declarations of Interest
There were no declarations of interest.
Resolved that: the minutes of the meeting held on 12 March 2015 were agreed as a correct record and signed by the Chair.
Appointment of Advisory Members for 2015/16
To re-appoint Grahame Snelling (HealthWatch) and Patricia Turner (Kingston Voluntary Action) as advisory members
Grahame Snelling, Chair of Healthwatch Kingston and Patricia Turner, Kingston Voluntary Action are re-appointed as Advisory Members for the 2015/16 Municipal Year.
Update from Adult Social Care
To receive an update from ASC on current developments
Hannah Doody, Acting Head of Operations, Adult Social Care gave an update on Adult Social Care.
The closure of Hobkirk House is on target for 31 July 2015. Only two permanent residents remain and options are being explored nearer to their families. Both residents are the responsibility of RBK. Two other residents had found alternative accommodation near their families and a further two had sadly passed away. There is engagement with the NHS on the future needs of the short term reablement beds which have been at Hobkirk House.
The Customer Voice Project is jointly between ASC and the CCG on the future model of services including older people’s accommodation needs. Engagement so far has been with over 80 residents and 100 staff. Four main themes have emerged:
· Understanding and being listened to – the health and social care system is complex for people to understand and navigate
· Co-ordination between organisations to meet people’s needs
· Choice and control and how outcomes are met following identification of needs
· Quality services – ensuring timely services and consistency of staff
In response to questions, Ms Doody stated that the identification process for contributors to the engagement exercise was to invite those who were already in contact with services. Councillor Netley suggested that the pool for the consultation needs to be much wider and Ms Doody agreed to take this point on board. In response to a number of further questions Ms Doody agreed to provide a written brief providing an overview of the report by C3 (the research company), details of the cost of the research and details of engagement with minority ethnic groups. Councillor Julie Pickering, Lead Member for Health, in the Gallery, explained the methodology used by C3 to ensure the validity of the responses received.
Ms Doody stated that prior to taking up her present post she had worked on implementing the Care Act in Kingston for 12 months. Implementation of the first phase is being monitored but it will take at least 6 months for outcomes to emerge. Guidance is awaited on implementation of Phase 2 (the funding reforms) but local preparation is already underway particularly on IT systems and much has already been achieved. Locally there are concerns about the large numbers of older people who are self funded and it will be important to ensure that the Council obtains appropriate funding. These areas are being explored with the Department of Health and Local Government Association. Kingston’s programme for training including a rolling programme, particularly on legal issues, is considered to be fit for purpose. Learning and training has also been shared across London as part of the London Programme.
1. Consideration is given to widen the consultation base for the customer voice project; and
2. A written brief on the research undertaken by C3 is circulated to members of the Panel
Update from Kingston Hospital NHS Foundation Trust
To receive an update from the Trust on current developments
A presentation on latest developments at Kingston Hospital was given by Dr Charles Bruce, Deputy Chief Executive and Duncan Burton, Director of Nursing and Patient Experience.
Achievements over the past year include:
· Dementia Strategy award from the Health Services Journal
· £100K received for investment in volunteering focussing on dementia and help with meals
· £830K received from the DH (out of £30M available nationally) for nursing technology enabling e-prescribing across the hospital, wireless observations with automatic patient records updates and alerts for patient deterioration
· New Boots Pharmacy on the Hospital site following a procurement process
· New Urology diagnostic unit
· Improvements to patient meals as this had previously been identified as a significant topic in patient feedback. These include warm cake in the afternoon, toast on demand, the aim being to encourage improved nutritional intake.
Details about performance reported to the Trust Board in early June included the following:
· Achievement of the 18 week referral to treatment target
· Achievement the 6 week standard for Diagnostics
· Cost Improvement Programme (CIP) agreed
· “Breaking the Cycle” Project which involved engaging with staff to consider ways of improving practice. One change, for example, has been to take blood samples earlier so that their results are available for morning clinical ward rounds
· A&E performance was good until November, but fell over the winter period and is only now beginning to recover. This is primarily due to the increasing numbers of older patients with more complex problems who are admitted to hospital via A&E.
· Delayed transfers of care has also been problematic and this has been experienced by a wide area beyond Kingston, including Surrey and engagement between the Hospital, community and social care departments is being improved
· Q1 has seen some shortfall in performance for 2 week breast symptomatic patients due to patient choice and administration reasons. Capacity is now in place to meet the standard. There have also been problems with 62 day cancer treatments although performance has now lifted to 85%.
Quality goals for the coming year are linked to the four Trust values - Caring, Safe, Responsible and Valuing Each Other. Examples are
Year 2 of the three year Dementia Strategy – an appeal has been launched to make further improvements to wards and become more dementia friendly
End of Life Care - the Trust has been nominated for a national award for work so far
The Trust has received a grant of £380K under the “Sign up to Safety” national programme which will enable a number of initiatives to be funded including the appointment of a Sepsis Nurse to help tackle Sepsis, one of the quality areas being progressed during 2015/16.
Catheter associated urinary infection is now the most significant of hospital acquired infection and work is taking across hospitals in South London to develop approaches to reduce this.
Pressure ulcers – continuing work in this area
Steps to provide Safer care for women in labour including foetal monitoring
Consultant services including seven day ... view the full minutes text for item 6.
Update from Kingston Clinical Commissioning Group
To receive an update from the CCG on current developments
Tonia Michaelides, Chief Officer, gave an update on progress over the past year. The CCG has been in place for two years and is now into its third year of operation. It is a small organisation with a significant agenda and employs 37 staff. The registered population for health services is about 30K larger than the resident Kingston population. The latest Annual Report and quality strategy are available on the CCG website.
The following points were highlighted:
The Care Quality Commission inspection of children and young people’s services was rated as good. A single point for access to Child Adolescent Mental Health Services (CAMHS) has been introduced and this has enabled earlier and better access for young people.
The integration of health and social care is a major priority for the current year, and the Better Care Fund initiatives supports this approach. The Kingston at home initiative is embedded and this too provides a firm foundation for future progress of integrated care.
The South West London Mental Health inpatient consultation was completed successful and this will introduced a modern 21st century facility to Tolworth Hospital. The community wellbeing service met all its targets. 19 GPs are undertaking an Advanced Diploma in Primary Care Mental Health and this will enable additional mental health provision in general practice. A Local Concordat has been developed between partner organisations to ensure mental health needs are met more effectively.
With the introduction of CCGs under the Health and Social Care Act, the responsibility for commissioning of Primary Care moved from PCTs to NHS England. Following an approach from NHSE, CCGs in South West London will begin co-commissioning of Primary Care Services with NHS England during 2015/16. The aim is to seek full delegation of responsibility as soon as possible and primary care budgets will be managed locally. GP practices are beginning to operate in a federated way. Rather than services being purely practice based, service delivery will move towards a population basis.
A Multiagency System Resilience Group is in place to improve outcomes and health systems for patients, particularly urgent care and for last winter a number of work streams developed new approaches to meet the additional winter pressures including the appointment of an acute care physician in A&E, and psychiatric liaison in Kingston Hospital and locality GP clinics at weekends. A Macmillan GP appointment has also been made to enhance clinical liaison for cancer services.
In relation to performance, the CCG has 161 targets. 116 (72%) of these were achieved, there was under achieved on 36 (22.4%) and 9 failed targets. Tonia Michaelides explained that the CCG’s targets relate to patients who live in Kingston and receive treatment at a range of hospitals including Kingston, St George’s, others in Surrey and elsewhere whereas Kingston Hospital’s targets relate to patients who are seen and treated at that hospital who may come from Kingston, Richmond and beyond.
CCG achievements included 18 week waiting times (99.2%), 6 week diagnostics, cancer targets with the ... view the full minutes text for item 7.
Update from South West London and St George's Mental Health NHS Trust
To receive an update from the Trust on current developments
Jonathan Mason, the newly appointed Service Director for the Kingston and Richmond Team, gave an update to the Panel. He confirmed that he would be leading the site developments at Tolworth Hospital.
He opened by drawing attention the late Councillor Chrissie Hitchcock’s role with the Home Treatment Team at Tolworth Hospital. She had joined the Trust in 1998. The Trust wished to pass on sincere condolences to her family in their sudden loss. Members of staff who had worked with Cllr Hitchcock had been allowed time away from their duties to attend her funeral on 8 June.
Jonathan Mason updated the Panel on progress with the Foundation Trust status application, estates and performance. He confirmed that the Trust Development Agency (TDA) had signed off the application which had now passed to Monitor for the next stage. It is anticipated that trust status will be granted in September or October 2015. The Trust is seeking nominations for appointments to the Council of Governors.
Updating on estates, it was confirmed that the first developments for new inpatient areas will be at Tolworth Hospital. Work at Tolworth will commence in 2019 and completion is anticipated by 2021 at both the Tolworth and Springfield sites. The estates developments are self funded by land disposals and residential developments and do not involve Private Funding Initiatives (PFIs).
Ward provision at Tolworth Hospital will include:
· 3 acute wards for functional mental illness
· 1 older people’s ward providing dementia care and older people’s functional mental illness
· 3 Child and Adolescent Mental Health (CAMH) wards located on a campus with school facilities
· 1 specialist services ward including for obsessive compulsive disorder (OCD) and body dysmorphia
The site will also include community mental health and crisis and home treatment older peoples support plus psychological therapies and other specialist services.
In terms of contractual arrangements, Jonathan Mason confirmed that these were still block contracts. A cost improvement plan (CIP) has been developed for this year. There will be some additional investment for the liaison psychiatry, street triage and crisis and home treatment services this year and but some funding will be removed from the Community Mental Health Teams for this year. These savings will be supported by transformation of older adults and adult services, administration and savings from ongoing vacancies. It is hoped that redundancies will be minimised.
Kingston and Richmond Clinical Commissioning Groups have worked to bring about a single point of access for the Child and Adolescent Service (referred to in Minute 7). Similar approaches are being developed for adults and older people. Work has also been undertaken to ensure that referrals are appropriate and all referrals are screened, triaged and forwarded to the appropriate services. As previously reported to the Panel the Trust is focussing on a recovery model and this involved agreeing goals with patients about what they wish to achieve following on from diagnosis and referral to the appropriate service.
In terms of performance most of the targets have been met in Kingston and ... view the full minutes text for item 8.
A presentation will be given on the development of the strategy
Helen Raison, Consultant in Public Health, gave a detailed presentation on the five year multiagency Dementia Strategy for Kingston upon Thames which will be implemented from the summer 2015. A short video was given which showed the disease progression over 7 years for an elderly woman. The presentation explained dementia, the symptomology and prevalence in Kingston. Current assessments are that there are over 1600 residents in Kingston who have diagnosed and undiagnosed dementia and this is expected to rise to over 1800 by 2020. Generally people with dementia also have at least one other health condition. Dementia is more common for people with learning disabilities.
The vision for the strategy is “People with dementia, their carers and family feel Kingston is a place where they can live well in the community, and is one of the best boroughs in the country for dementia care and support”.
The draft strategy (which was circulated to members of the Panel) sets out the case for change for the way that organisations and communities in the borough should respond to the needs of people with dementia. There are four main sections:
· Improving wellbeing, raising awareness and reducing risk
· Timely diagnosis, assessment and intervention
· Living well with dementia & increasing support in the community
· High quality care in times of crisis, care home and end of life care
It includes a comprehensive set of objectives and draws on a consultation which took place during the summer of 2014. The outcomes for the strategy are:
· I was diagnosed early
· I understand, so I make good decisions and provide for future decision making
· I get the treatment and support which are best for my dementia
· I am treated with dignity and respect
· I know what I can do to help myself and who else can help me
· I can enjoy life
· I feel part of a community and I am inspired to give something back
· I am confident my end wishes will be respected
The Strategy was welcomed by members. During discussion a member put forward a suggestion that following on from the dementia awareness week held last year that there should be an annual activity for dementia to continue to raise awareness in the community. Attention was drawn to the importance of support for carers including provision of respite care to enable breaks. A further need was for appropriate training in dementia care for carers working in care homes, the possible need for cultural sensitivity and also that administrative and reception staff in GP surgeries may require awareness training to provide a degree of flexibility around practicalities for people with dementia and their relatives.
In relation to a question about the possible introduction of hospital passports similar to those for people with learning disabilities, Helen Raison agree to provide a response to this suggestion outside of the meeting.
The Chair thanked Helen Raison for her presentation.
1. The suggestions made by the Panel are considered during implementation of the strategy, and
2. A response to ... view the full minutes text for item 9.
To receive, discuss and agree proposals
The proposed working arrangements for 2015/16 sought to develop the scrutiny role of the Panel and to respond to feedback from the Peer Review of the Health and Wellbeing Board which took place in March 2015. This suggested that the Panel widens its public accountability and increases its focus on areas which would be of most benefit to the local health economy.
A number of practical approaches were put forward to strengthen the Panel’s approach to scrutiny and the report provided details about the future direction of health and social care outlined in the Queen’s Speech delivered on 27 May 2015 i.e. the implementation of the NHS 5 year plan, integrating healthcare and social care, ensuring 7 day working, improving access to GPs and mental health care.
1. The current terms of reference for the Panel (unchanged) are noted;
2. A further attempt is made to obtain local GP advisory representation;
3. a) A member working group is appointed to draw up a limited program of future scrutiny topics and influence the direction of these reviews;
b) The following members are appointed to the working group:
Councillor Maria Netley
Councillor Rachel Reid
Councillor Mary Clark
Councillor Linsey Cottington
c) The Chair or Vice Chair would also participate in the group;
4. One meeting a year will be held at an external partner venue;
5. One scrutiny topic should be nominated by local residents; and
6. The Panel will consider notable topics covered by the Health and Wellbeing Board.
To receive and discuss the annual report
The Annual Report summarised the work of the Panel during 2014/15. With the changes in the administration and membership of the Panel the first meeting received introductory presentations from health and social care. The Panel then covered a wide range of issues and topics at the remaining four meetings. Some of the key topics responded to current events such as the Ebola crisis, parking problems at Kingston Hospital and the introduction of the Care Act. Others responded to requests from members of the public, for example, Gosbury Hill GP led health centre and transport links to hospitals for residents in South of the Borough. The Panel also looked at maternity services, progress at the Royal Eye Unit, voluntary community support for people with dementia as well as the consultation on mental health inpatient services,from a Kingston perspective, plus a number of further topics.
Agreed that: the report is noted
Health and Wellbeing Board
To note that the next meeting takes place on 24 June 2015 and the Board will be considering the outcome of the LGA Peer Review of the HWB which took place in March and updates on the Joint Health and Wellbeing Strategy and the Better Care Programme.
(The previous minutes were received by the Panel in March).
The minutes of the last Health and Wellbeing Board meeting were received by the Panel at the meeting on 12 March 2015. The next meeting of the Board would take place on 24 June 2015 and updates on the Joint Health and Wellbeing Strategy and Better Care Programme would be considered as well as the outcome of the LGA Peer Review of the Board in March 2015.
Agreed that: Panel members are encouraged to attend the Board meetings.