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.

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Venue: Guildhall, Kingston upon Thames

Contact: Marian Morrison 020 8547 4623  email:  marian.morrison@kingston.gov.uk

Items
No. Item

25.

Questions

To consider questions from the gallery on items which are not on the agenda

Minutes:

There were no questions.

26.

Apologies for absence and attendance of substitute members

Minutes:

Apologies were received from Councillors Linsey Cottington and Shiraz Mirza.

27.

Declarations of Interest

Minutes:

There were no declarations of interest.

28.

Minutes

To confirm the minutes of the meeting held on 28 September 2016

Minutes:

Agreed that:  the minutes of the meeting held on 28 September 2016 were confirmed as a correct record.

29.

Care Quality Commission Inspection of South West London & St George's Mental Health Trust pdf icon PDF 105 KB

To consider a briefing report on the CQC inspection and actions taken by the Trust to address the shortcomings.  Officers from the Trust will attend to update the Panel and answer questions.

Additional documents:

Minutes:

The report provided a summary of the CQC inspection report published on 16 June 2016 following the CQC’s visit in March 2016.  All providers are required to be registered with the CQC before they can offer regulated care activities.  The registration process ensures that providers reach specified standards concerning the care facilities, policy systems and procedures and how they are run.  Once registered all providers are regularly monitored by the CQC. 

 

During the course of inspections five key questions are pursued:  Are Services Safe, Effective, Caring, Responsive and Well-led?  The overall rating of all of the services was requires improvement.  Of the ten service areas, seven were rated as good.  Three were rated as requiring improvement i.e.

                                                                                                           

·         Long stay/rehabilitation mental health wards for working age adults                                    

·         Community based mental health services for adults of working age                                     

·         Community based mental health services for older people                                                     

 

However, the CQC also stated that there is much for the Trust to be proud of including the commitment of the senior executive team to improving services and provide a high standard of services.  There has also been significant improvement in the care pathway.  Comment was made about the improvements in the management of access to acute beds across the Trust and facilitation of practical arrangements associated with discharge.   Most community teams were meeting their targets for assessing and treating people in a timely manner.  The Trust board provides effective challenge to ensure the Trust meets its objectives and there is a largely healthy culture and good relationships with patients.

 

The main areas for improvement were around:

 

·         Support on rehabilitation wards to enable patients to achieve independence

·         Need for better identification on forensic and CAMHS wards where patients are being secluded and ensuring observations and medical review take place appropriately

·         One to one professional individual supervision of staff was patchy in the community

·         Recent changes around centralisation of administrative support (now at Kingston) had resulted in poor standards for communications with patients and GPs about appointments etc but the report noted that this situation was improving

·         Risk assessment needs to improve across a number of teams

 

A number of Requirement Notices were issued and these related to aspects of supervision, seclusion, risk assessment, medicines management, skill mix and support to implement the recovery model in rehabilitation services.

 

Details from the Trust’s July and October board papers were also given.  The CQC have confirmed that the Trust was on the borderline of a “good” rating.  Following actions by the Trust and a further visit by the CQC in September 2016, the CQC have confirmed that the Trust had made very positive progress and all regulatory requirements had been met. 

 

Dr Whicher confirmed that the CQC reviewed all service areas of the Trust with the exception of some of the specialist services and all services were rated as good for caring and most were rated as good for being well-led.  The trust was also praised for its safeguarding arrangements.  The CQC also identified areas which if addressed could  ...  view the full minutes text for item 29.

30.

Kingston Clinical Assessment Service and access to GP appointments pdf icon PDF 93 KB

To note and scrutinise the report about KCAS and recent developments including GP access.  The Director of Planning and Primary Care, KCCG, will attend to update the Panel and answer questions

Minutes:

This item had been requested by Councillor Mary Clark.  The report stated that the Kingston Clinical Assessment Services (KCAS) had been introduced in 2006 to support GP practices making routine (non-emergency) outpatient referrals through the Choose and Book system and to ensure that referrals were appropriate for the patient’s condition.  The Panel had been requested to review KCAS as there had been suggestions that the service was giving rise to delays in appointments.   The Panel found that KCAS was innovative and had received national acclaim by the Department of Health.  Many of the initial teething problems which prompted the review had been resolved and it was noted that the KCAS approach had helped raise GPs’ awareness of alternative clinical approaches to patients’ conditions.  The Panel also learned of a significant cost saving which was being delivered at the time. 

 

Updates were received by the Panel in December 2007 and June 2009.  Confirmation was given that KCAS ensured that patients received the “right treatment” rather than simply “treatment”.  However, the Panel also learned that hospital consultants felt that KCAS introduced delays into the system and GPs did not require a filtering mechanism. 

 

A new electronic method of making referrals “e-referral” was introduced by the NHS in 2015 which addressed many of the functional weaknesses of the previous Choose and Book system and is simpler.  Two GP practices in Kingston have piloted e-referral to test how much of the referrals process could be undertaken by practices.  The CCG is currently reviewing referral processes including the role of KCAS and consultation on proposals is expected in the new year.

 

The report also set out information about the new arrangements for GPs to provide Saturday appointments in Kingston and changes will be introduced to enable all patients in Kingston to book Saturday morning appointments with a GP or nurse by April 2017.  Practices will also be providing dedicated appointments for children to ensure sick children can be seen by a GP quickly.

 

In October Surbiton Health Centre started providing a primary care extended service on Saturdays and Sundays from 8am to 8pm which is available to all.  The CCG plans to open two more such services by April 2017 which will include offering appointments from 8am to 8pm seven days a week.  The CCG will be piloting a single point of access via phone to book appointments across a number of practices so that if an appointment is not available at a patient’s usual practice they can be offered an earlier appointment at a surgery nearby.

 

Kathryn MacDermott explained that the CCG was looking to use KCAS resources more effectively and it was consulting staff.  The GP clinical triage element within KCAS will continue and may be extended but the current administrative team arrangements will change and freed-up skills and resources will be used to support practices differently.  A paper outlining the proposals and options will be presented to the CCG board on 10 January 2017 and a 30-day consultation will follow.  The  ...  view the full minutes text for item 30.

31.

Presentation on Stay Well this Winter

The Director of Quality and Engagement, KCCG, will give a presentation to update the Panel and answer questions

Minutes:

Fergus Keegan gave a detailed presentation on “Stay well this winter”.  He explained that this was the second year of the national campaign led by the Department of Health, Public Health England and NHS England with minor changes on last year’s campaign.  The CCG would be following this and but also include some local key messages.  The national campaign calendar was included.

 

The main national campaign brief is “to ensure that people who are most at-risk of preventable emergency admission to hospital are aware of and, where possible, are motivated to take actions what may avoid admission this winter”.  It would focus on C to DE Adults age 65+, people with long term conditions (LTCs) and their carers, whilst increasing take up of flu vaccine especially for pregnant women, parents with children age 2 – 7 and people with LTCs.  LTCs include asthma, chronic obstructive pulmonary disease, and diabetes and these can be exacerbated if people fall unwell with flu.  He emphasised that the campaign is not about preventing admissions among target groups, but to help them stay well to avoid the need for a visit to hospital.  Key messages include seeking advice from pharmacists at the first sign of feeling unwell, stocking up with medicines, prescriptions and food ahead of the holiday period, keeping warm, having a flu vaccination and keeping an eye on elderly or frail friends, neighbours and relatives.

 

The local plan included arrangements for primary care access – which for this winter included:

 

·         Weekend services at Surbiton Health Centre offering booked in advance appointments and appointments available on the day for registered and non-registered patients.  (Two more weekend walk in services would be operational by 1 April 2017 in North Kingston and Chessington/Hook).

·         Saturday morning GP clinics (walk-in and booked) at Berrylands Surgery, Canbury Medical Health Centre, Chessington Park (alternate weeks), Orchard Practice, Claremont Medical Centre, Fairhill Practice, Groves Medical Central Holmwood Corner. Kingston Health Centre, Manor Drive Medical Centre, West Barnes Surgery for patients registered at those practices.

·         Same Day consultation for children under 10 years old (inclusive) at Berrylands Surgery, Brunswick, Canbury Medical Health Centre, Groves Medical Centre, Kingston Health Centre, Orchard Practice

·         Mental Health Street Triage

·         GP in A&E available 18 hours per day and currently seeing 50-60 patients per day

 

A detailed communication plan had been developed using a range of actions including free NHS materials, information on the CCG’s website and twitter, help from local partner organisations and neighbourhood notice boards, media engagement and a number of engagement activities including stalls at Christmas light switch on events.  Any assistance members could provide in distributing leaflets or forwarding electronic versions would be welcomed.

 

Local key messages are about locations of weekend walk-in access including Saturday morning appointments and same day consultations for children under 5, plus self-care and keeping warm, and avoiding slips and trips.

 

Questions were asked about the locations of the primary care extended services and a request was made that one be sited in New Malden.  It  ...  view the full minutes text for item 31.

32.

Minutes of the Health and Wellbeing Board pdf icon PDF 118 KB

To consider the minutes of the Health and Wellbeing Board held on 22 September 2016 and to note that there is a further item on Kingston Co-ordinated Care was discussed at the HWB meeting on 15 November 2016.

Minutes:

Agreed that:  the minutes of the Health and Wellbeing Board held on 22 September were noted.

33.

Work Programme

To discuss and agree the work programme:

 

Thursday 12 January 2017

 

·         Air Quality

 

Tuesday 24 March 2017

 

·         Kingston Co-ordinated Care including

·         Communication and publicity about Kingston Co-ordinated care and direct payments

·         Community arrangements to support discharge processes

 

·         Public Health Report

 

·         Update on commissioning the integrated diabetes service

 

Please note:  the work programme is provisional and subject to change

Minutes:

The Chair advised the Panel that he had received a request for the Panel to consider the Kingston Safeguarding Adults Board Annual report at the January meeting.  Grahame Snelling during discussion on the SWLSTG CQC inspection report requested that the Panel invite Camden and Islington Mental Health Foundation Trust to discuss their CQC inspection findings as the Trust provides some services to Kingston residents.

 

Agreed that:  the work programme for remaining meeting in the 2016/17 municipal year is:

 

Thursday 12 January 2017

 

·         Air Quality

·         Kingston Safeguarding Adults Board Annual Report

·         Camden and Islington Mental Health Foundation Trust CQC inspection report – services provided in Kingston

 

Tuesday 24 March 2017

 

·         Kingston Co-ordinated Care including:

o   Communication and publicity about Kingston Co-ordinated care and direct payments

o   Community arrangements to support discharge processes

·         Public Health Report

·         Update on commissioning the integrated diabetes service