Agenda and minutes

There were no disclosable pecuniary interests declared.

The minutes of the meeting held on 30^th July, 2014 were agreed as a true record.

Further to Minute 3 headed ‘Quality Accounts’, the Chair Councillor Thomas informed that he had received a response from the Trust in reply to his letter about their decision to allow the Chief Executive of West Midlands Ambulance to undertake his role on a part time basis. He intended to pursue the matter further.    

Briefing Note of the Assistant Director, Safeguarding, Performance and Quality

The Chair and Vice-Chair of the Safeguarding Board have been invited to the meeting for the consideration of this item, and for item 5 below

The Scrutiny Board considered a briefing note of the Executive Director, People concerning the Annual Report of the Coventry Safeguarding Adults Board 2013/2014. A copy of the report was appended to the briefing note and the Board considered the contents of this report. Joan Beck, the new independent chair of the Board attended the meeting for the consideration of this item along with Brian Walsh, the previous chair. 

The briefing note set out the background to the Coventry Safeguarding Adults Board which was a multi-agency partnership made up of statutory sector member organisations and other non-statutory partner agencies. The Board were informed that under the new Care Act, it would become a statutory requirement for each area to have a Safeguarding Adults Board.

The Board had strategic responsibility for the development, co-ordination, implementation and monitoring of policies and procedures that safeguard and protect vulnerable adults in the city. Through its work, the Board promoted the welfare of adults at risk and their protection from abuse and harm.

The Annual Report for 2013/14 introduced the implications of the Care Act 2014, much of which was to become effective from April 2015. It highlighted the work of the Board, its partners and sub groups over the previous year. The Board’s five key priorities for the coming year were detailed. Particular reference was made to the low proportion of alerts which proceeded to referrals, which had previously been raised as a concern.

Attention was drawn to the good to excellent attendance from all partners at Board meetings.

The Board questioned the officers on a number of issues and responses were provided. Matters raised included:

·  Councillor Hetherton’s observer role on the Board and the suggestion that consideration be given to the appointment of Councillors as full members of the Board

·  Ways of raising public awareness of about adult abuse and details of the Board’s communication strategy including lead responsibility

·  The potential to draw more attention to key achievements

·  Areas for improvement which included the intention to have a collective ownership of future reports and the opportunity for close working with the Safeguarding Children Board

·  Further information about safeguarding alerts and referrals

·  A concern about the low rate of referrals recorded for people in minority ethnic groups and the importance of engaging with these communities

·  A request for clarification about the multi-agency hub

·  Levels of support from the Police and the Crown Prosecution Service

·  Details about organisational representation on the Board.

RESOLVED that:

(1) The analysis of the low rate of conversion of alerts to referrals which relate to a previous Scrutiny Board discussion following on from the Adults Social Care Peer Review in March 2014 be noted.

(2) Joan Beck, the Chair of the Board, to give consideration to the future appointment of Councillor representatives on the Board.

(3) The Executive Director, People to provide a briefing note to members on the location and purpose of the multi-agency safeguarding hub.

Report of the Executive Director, People

The Scrutiny Board considered a report of the Executive Director, People providing a brief overview of the Adult Social Care Annual Report for 2013/14 (Local Account) which described the performance of Adult Social Care and the progress made against the priorities set for the year. A copy of the draft Annual Report was set out at an appendix. A copy of the final designed version of the report had also been e-mailed to members prior to the meeting. The report was also to be considered by Cabinet at their meeting on 7^th October, 2014.

The report indicated that Councils were expected to produce a Local Account that demonstrated the performance of adult social care to local citizens. It provided the opportunity to be open and transparent about the successes and challenges of the year and to show how outcomes were improving for the people Adult Social Care supports. The Board were informed that this was not a statutory document.

The annual report used information taken from the Adult Social Care survey. It identified key challenges which included the introduction of the Care Act in April 2015; the Better Care Fund; and managing with a reducing financial resource. The report would be shared with local people, people who use services, carers and partner agencies. Their feedback would inform the approach to producing next year’s report. 

The Board noted that the commentary from Healthwatch Coventry was still awaited. 

Members of the Board questioned the officers and responses were provided. Representatives from University Hospital Coventry and Warwickshire, Coventry and Rugby CCG and Coventry and Warwickshire Partnership Trust who were in attendance also responded to questions. Matters raised included:

·  Clarification as to when the response from Healthwatch Coventry would be received

·  An explanation about the net spend on services, in particular the largest amount spent on residential costs and the likelihood of this increasing

·  An understanding of the monitoring undertaken ensuring adults were supported to move back/remain in their own accommodation

·  An update on the latest position concerning pooled budgets

·  Clarification about the support for partnership working including new ways of working which aimed to prevent the vulnerable going into hospital care

·  Concerns about reduced funding having an impact on the services available to support mental health patients and the difficulties associated with the unavailability of GP appointments

·  Further information about the implications of the Care Act in relation to self-funders of residential care who, in the future, will be entitled to financial support from the Council, the impact of which could be very significant.

RESOLVED that:

(1) The Board support the publication of the Annual Report.

(2) A briefing note be submitted to Cabinet at their meeting on 7^th October, 2014 informing of the Board’s considerations including asking Cabinet to consider further the use of pooled budgets to support better partnership working, cost savings and improved service delivery.

(3) The Annual Report for 2014/15 to be submitted to the Scrutiny Board when the commentary from Healthwatch Coventry has been included in  ...  view the full minutes text for item 12.

Briefing note of the Scrutiny Co-ordinator

To consider the Quality Account, Mark Radford, Chief Nursing Officer, UHCW has been invited to the meeting for the consideration of this item

Further to Minute 3/14, the Scrutiny Board considered a briefing note of the Scrutiny Co-ordinator introducing the Quality Account 2013/14 for University Hospitals Coventry and Warwickshire (UHCW). A copy of the Account was set out at an appendix. Mark Radford, Chief Nursing Officer, UHCW attended the meeting for the consideration of this item.

Quality Accounts were annual reports to the public from providers of NHS healthcare services about the quality of services they provided. Their purpose was to encourage boards and leaders of healthcare organisations to assess quality across all their services and to engage in the wider processes of continuous quality improvement. The Scrutiny Board had the opportunity to provide a commentary on local Trust’s Quality Accounts and reference was made to the Task and Finish Group which undertook this task.

The annual report referred to the following three priorities for 2013/14:

(i) Patient Safety: Reducing the risk of harm from falls

(ii) Clinical Effectiveness: Discharging patients in a safe and timely way

(iii) Patient Experience: Using patient feedback to improve care

Priorities for the present year were:

a) Patient Safety: Ensuring effective handover of care between health care professionals

b) Clinical Effectiveness: Ensuring that patients flow easily through the hospitals to improve efficiency in elective theatres

c) Patient Experience: Ensuring that the hospitals work together towards providing a world class patient experience

The Board questioned the representative on a number of issues and responses were provided. Matters raised included:

·  The implications of inappropriate patients turning up at A and E because they can’t get a GP appointment

·  How the transport issues for patients attending the renal unit were being addressed

·  How the issue of staff performing tasks for patients without giving them proper care and compassion was being managed

·  Further details about improving patient experiences including using the TMI patient experience innovation model

·  The importance about the standard of hospital food and the availability of car parking to improve patient experience as indicated in the family and friends test for in-patients

·  Proposals for dealing with the problems caused by allowing smoking outside of the hospital

·  This issue of patients being unable to be discharged due to the unavailability of their prescription drugs

·  The success of the Lucina birth centre at the Coventry hospital

·  Clarification that the hospital was on track to deliver all the requirements of the Francis Report

RESOLVED that, having considered the content of the Quality Account, representatives from University Hospitals Coventry and Warwickshire be invited to attend a future meeting of the Scrutiny Board to discuss the implementation of the requirements of the Francis Report.

Joint presentation

David Eltringham, Chief Operating Officer, UHCW and Sue Davies, Head of Partnerships, Coventry and Rugby CCG have been invited to the meeting for the consideration of this item.

The Scrutiny Board received a joint presentation which provided a review of the winter and patient discharge from University Hospitals Coventry and Warwickshire (UHCW). David Eltringham, Chief Operating Officer, UHCW and Sue Davies, Head of Partnerships, Coventry and Rugby Clinical Commissioning Group attended the meeting for the consideration of this item.

The presentation indicated that in the past year the hospitals had dealt with 180,000 Emergency Department (ED) attendances; 38,000 elective procedures and 680,000 outpatient appointments. Detailed information was provided on the monthly ED performance for meeting the four hour standard which included a comparison with attendance numbers.

The Board were informed about the principles for getting emergency care right (FREED metrics) and details were provided about the increasing number of patients attending A and E over the past three years including numbers conveyed by ambulance and admissions to hospital. There was also a focus on discharges including the weekly net admit/discharge position. The presentation concluded with details of the measures being taken by the hospitals to support improved performance.

The Board questioned the representatives on a number of issues and responses were provided, matters raised included:

·  Clarification about the discharge figures and information on re-admissions

·  Details about the proposals for seven day working

·  Partnership working to support improved hospital patient flow including reducing delayed discharges

·  Details about the multi-agency funded street triage pilot scheme including concerns about the funding arrangements

·  The implications associated with the unavailability of GP appointments.

RESOLVED that the presentation be noted and the Scrutiny Board to be kept informed of progress and any particular trends concerning winter pressures and patient discharge from University Hospitals Coventry and Warwickshire.

All outstanding issues have been picked up in the Work Programme

The Scrutiny Board noted that all outstanding issues had been included in the Work Programme for the current year.

Report of the Scrutiny Co-ordinator

The Scrutiny Board considered the Work Programme for 2014-15.

RESOLVED that the following issues be added to the work programme:

(i) Services for mental health patients, minute 12 above refers

(ii) Implementing the requirements of the Francis Report, minute 13 above refers

(iii) When considering the ‘Overview of the Care Bill’ issue, information be provided on the preparations of the Adult Safeguarding Board

(iv) The item on ‘Complaints Management’ to include Adult Social Care

(v) ‘Coventry and Warwickshire Partnership Trust, Progress following CQC Inspection’ to be considered at the November meeting of the Board.   

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

There were no other items of urgent public business.