Items
No. |
Item |
1. |
Minutes of the meeting held on 16 July 2014 PDF 58 KB
Decision:
Resolved: to agree the minutes of the meeting
held on 16 July 2014 as an accurate record.
Minutes:
Resolved: to agree the minutes of the meeting
held on 16 July 2014 as an accurate record.
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2. |
Declarations of interest PDF 26 KB
Minutes:
Councillor Muldoon declared a non-prejudicial
interest as an elected governor of the South London and Maudsley
NHS foundation trust.
Councillor Bell declared a non-prejudicial
interest a member of Keep Our NHS Public and the Socialist Health
Association.
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3. |
South East London five year commissioning strategy PDF 17 KB
Additional documents:
Decision:
Resolved: to note the update.
Minutes:
Dr Marc Rowland (Chair of
Lewisham Clinical Commissioning Group) and Martin Wilkinson (Chief
Operating Officer, Lewisham Clinical Commissioning Group)
introduced the report; the following key points were
noted:
- Over the last 18
months, Lewisham had been involved in the process of developing a
five year commissioning strategy with the other South East London
boroughs.
- The intention was to
ensure that there was a coordinated approach to improving the
health of the entire population of South East London.
- An integrated system
model had been developed, which set out how the different aspects
of healthcare would work together.
- Creating strong and
resilient communities was at the foundation of the
model.
- The strategy was wide
ranging in its ambitions. Some of the approaches required by the
strategy were already in the process of being developed. Further
work needed to be agreed, which would be developed in the context
of the adult integrated care programme.
- Commissioners had
also sought to involve the community and voluntary sector in the
development of the strategy.
- Members of the public
and Healthwatch had been engaged in the consultation.
- There would be
further changes to strategy in the coming year.
- Future versions of
the strategy would enhance the focus on health and social care
integration.
In response to questions from
the Committee, the following key points were noted:
- There was no
outsourcing requirement as part of the strategy.
- Specialist treatments
for brain trauma and cancer were the responsibility of NHS
England.
- It was recognised
that the strategy was ambitious. It was too early to tell whether
it would all be achieved, but without the changes proposed, the
delivery of Healthcare in Lewisham would become increasingly
financially difficult.
Resolved: to note the update.
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4. |
Improving district nursing PDF 152 KB
Decision:
Resolved: to note the update.
Minutes:
Alison Browne (Nurse Director,
Lewisham CCG) and Claire O’Brien (Deputy Director of Nursing,
Lewisham and Greenwich NHS trust) introduced the report; the
following key points were noted:
- Provision of district
nursing had been moved between a number
of different providers in the past few years, without much positive
change to ways of working.
- A number of concerns
had been raised about district nursing from different sources,
including GPs.
- An audit of the
service had been instigated in partnership between the providers
(Lewisham and Greenwich NHS Trust) and commissioners (Lewisham
CCG).
- The review found that
there were a number of areas for improvement, which, whilst
requiring action, were not thought to be unique to services in
Lewisham.
In response to questions from
the Committee, the following key points were noted:
- The audit reflected
issues with the service; however, these issues had also existed
under the primary care trust.
- An action plan had
been developed to improve the service. The plan was linked with the
actions developed in response to the recommendations of the Francis
report.
- The vision for district
nursing was being delivered. Work was taking place to integrate and
improve services and the direction of travel was positive.
- Some basic issues had
been addressed, such as standards for uniform and medical
equipment.
- Measures had also
been developed to deal with issues in more complex areas, such as
culture and values.
- A new training plan
had been implemented, which began on the 1st of
September.
- Training included
information about staff responsibilities in relation to protected
characteristics.
- The service was being
integrated between the hospital and GP surgeries into area based
teams.
- There was a new single
assessment process for people requiring district nursing, which was
accompanied by a single set of paperwork.
- It was hoped that further
integration would reduce duplication and paperwork.
- As had been widely
reported, the NHS computer system had not achieved its stated
objectives but it was hoped the process for accessing district
nursing would eventually be electronic.
- There had been an issue
with the retention of staff but it was hoped that the improvements
to the service would improve the situation.
- The review had created an
opportunity to reaffirm the fundamental set of skills required for
nursing in Lewisham.
Resolved: to note the update.
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5. |
Better Care Fund update PDF 37 KB
Decision:
Resolved: to note the update.
Minutes:
Sarah Wainer (Head of
Improvement, Strategy and Partnerships) introduced the report; the
following key points were noted:
- The Better Care Fund was a
£3.8b pooled budget introduced by the Government for the
integration of health and social care.
- This was not new money. £1.9bn was existing funding that in 2014
had been allocated across health and social care. The remainder would come from CCGs budgets.
- A first draft of
Lewisham’s Better Care Plan was submitted to NHS England in
April. Following the deadline for submission, implementation of the
Fund was put on hold nationally. A further submission was to be
made on 19 September.
- New requirements had been
issued for the fund. The payment for
performance element was now solely related to the
planned reduction in total emergency admissions.
- There had been a lack of
specific feedback from Government about the initial plan submitted
so officers had requested further information in order to work on
areas to be strengthened.
- The new timetable for the
scheme left only two weeks in which to align the Council’s
plans for the implementation of the Care Act with revised plans for
the Better Care Fund.
- The Care Act put a
requirement on Councils to provide assessments for informal care
providers from April 2015. There would be some changes to the kinds
of organisations that would be eligible for funding.
- Some of the biggest
changes would be in the provision of respite care.
- Some generic, universal
services were required by carers. Complex assessments would also be
required for some carers, such as those with combined care and
caring responsibilities.
- Work was taking place to determine the costs of the
new arrangements.
- Young carers had the same
right to an assessment as adults.
Sarah Wainer (Head of
Improvement, Strategy and Partnerships) and Aileen Buckton
(Executive Director for Community Services) responded to questions
from the Committee; the following key points were noted:
- The Government had
announced plans for a new national minimum threshold for
eligibility criteria – which would only recognise substantial
and critical needs.
- It was difficult to judge
how much the implementation of the Care Act would cost. The Council
would have an estimate by April – a number of carers would
not request a full assessment as some would rather have advice,
information and direction to support services. There was a duty in
the Act to provide preventative services.
- There would be no
new money coming into the system.
- The Council’s
community connections project was designed to tackle social
isolation. It had been found that carers also appreciated the
opportunity to use these services.
- The Government target for
a 3.5% reduction in emergency admissions would be extremely
challenging.
Martin Wilkinson (Chief
Officer, Lewisham CCG) responded to questions from the Committee;
the following key points were noted:
- Recent bed audits
indicated that there were a number of patients that didn’t
need to be in hospital beds. Partners in Lewisham would continue to
work closely together to free up hospital beds.
- Partners were committed to
...
view the full minutes text for item 5.
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6. |
Select Committee work programme PDF 97 KB
Additional documents:
Decision:
Resolved: to agree changes to the work
programme, as discussed.
Minutes:
Timothy Andrew (Scrutiny Manger) introduced
the report. The Committee then discussed the work programme. The
following key points were noted:
- The Chair of the Health and
Wellbeing board would be invited to the next meeting of the
Committee.
- The next meeting would be held at
Lewisham Hospital.
- Aileen Buckton would advise members
of the date for an all member briefing
and all member tour of the hospital.
- An update would be provided on the
timing of the public health annual report.
- Campaign for Lewisham Autistic
Spectrum Disorder would be invited to a future meeting to discuss
their ambitions for joined up housing and social care in
Lewisham.
Resolved: to agree changes to the work
programme, as discussed.
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7. |
Referrals to Mayor and Cabinet
Decision:
Minutes:
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