Adult Services and Health Select Committee Minutes

Tuesday, 28th July, 2015
Conference Room 2, Municipal Buildings, Church Road, Stockton on Tees, TS18 1LD
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Mohammed Javed(Chairman), Cllr Michael Clark(Vice-Chairman), Cllr Sonia Bailey, Cllr Evaline Cunningham, Cllr Kevin Faulks, Cllr Lynn Hall, Cllr Stefan Houghton, Cllr Mick Moore, Cllr Tracey Stott, Deborah Miller
Daniel Childs (DSU), Liz Hanley (CESC), Peter Mennear (Scrutiny)
In Attendance:
Lynn Wightman (STEPS Manager, Adult Services), Jenny Barrett (Practice Manager, Tennant Street Medical Practice and A&B Medical Practice), Dr Jonathan Berry (Tennant Street Medical Practice and A&B Medical Practice), Ruby Poppleton (Heath Improvement Specialist, Public Health)
Apologies for absence:
Dr Paul Williams (Tennant Street Medical Practice and A&B Medical Practice)
Item Description Decision
The Evacuation Procedure was NOTED.
There were no Declarations of Interest
AGREED that the minutes be approved.
AGREED that:-

1) the information be noted;

2) the proposed merger of Tennant Street Medical Practice, and A + B Medical Practice be supported.

3) the response from the CCG on Patient Registration issues be circulated when available, and the Chair and Vice-Chair review how to take the issue forward.
AGREED that:-

1) The information in the Briefing Report be noted;

2) The scope of the Review be agreed subject to the amendments above.
Consideration was given to the project plan and it was noted that the following items would be presented at future meetings:

- Healthwatch Annual Report and Update (8 September 2015)

- Review of Access/Take up for people with LD review (8 September 2015)

- Regional Health Scrutiny Update (8 September 2015)

- Inspections (various)
AGREED that Members note the Chair's Update


Consideration was given to the draft minutes of the meeting held on Tuesday 16th June 2015.

Referring to issues surrounding new patient registration at GP surgeries, Members requested that it be noted that they believed NHS England had no adequate system in place to monitor residents being refused admittance to GP lists.
The Committee received information regarding to the proposed merger of Tennant Street Medical Practice and A&B Medical Practice) and Dr Jonathan Berry (Tennant Street Medical Practice and A&B Medical Practice) which included:

- The background/context of the proposed merger;

- The objectives and aims which inform the merger;

- Stakeholder engagement;

- Equality Impact Assessment;

- Potential Risks;

- The timescale of the merger.

The increasing difficulties in relation to the provision of a single-handed GP Practice were discussed. It was noted that following the operation of joint management with Tennant Street, there had been a significant reduction in locum cover at A & B compared to the same period in the previous year.

Members held discussion on the information and raised the following questions/queries:-

- Members enquired as to distance between the two surgeries. They were informed that walking between Tennant Street Medical Practice (TSMP) and the A & B Medical Practice had been timed and took 7 minutes. Members also heard that a bus stop was situated outside TSMP, which would make journeys via public transport more convenient for some patients.

- Members raised concerns about parking arrangements. It was suggested that the parking/drop-off situation had improved recently, and was it also considered that future redevelopment of the area could possibly alleviate any future issues arising.

- Members asked whether the practice expected to increase patient numbers in the near future. Members were informed that no influx of new patients was expected and that numbers fluctuated, depending on the admission of new patients to other practices in the area. Members stated that they had been told that no patient lists were closed in the area, so all practices should have been accepting new patients. TSMP representatives stated that they had heard anecdotal evidence that other practices were refusing to admit new patients to their lists. It was noted that Woodlands Practice had recently formally applied for a temporary list closure.

Subsequently, Members discussed a letter from NHS England, in response to the Committee, regarding residents being unable to register as new patients. Committee Members noted that they were dissatisfied with the response on the issue to date and wanted to look into the matter further. The issue had first arisen during the Committee’s review of Access to GP and Urgent Care during 2013-14. While Members were displeased with the response from NHS England, the Committee would urge the CCG to provide its response before deciding what further action to take.

- Members queried the ratio of staff to patients following the proposed merger. Members heard that the surgeries were well staffed in comparison to the national average. Representatives stated that TSMP had a better than average ratio and that the situation would be maintained following the merger with A + B Medical Practice.

- Members asked for and were provided with information about the funding of facilities at TSMP and A & B Practices.

- It was noted that A & B moving out of the relatively new Endurance House would lead to two more rooms being available for part of the time, but that some services were still in the building including North Shore Practice, Arrival, and some community services.

-The links to the specialist Arrival Practice for asylum seekers and refugees were queried. It was explained that Arrival Practice was not affected by the proposals.
Members considered a Briefing Paper as part of the Review of Access to Services by people with learning disabilities, which included information relating to:

- The difference between a learning difficulty and learning disability;

- The local Learning Disability Population;
- Autism;
- Joint Health and Social Case Learning Disabilities Self-Assessment Framework 2014 / IHaL;
- Reducing premature mortality in people with learning disabilities;
- Transforming Care work programme;
- Learning Disability Partnership Board;
- Inclusion North Membership;
- Safe Place Scheme;
- Council Adult Care Services for People with Learning Disabilities;
- Community Bridge Building; and
- A Community Bridge Building Case Study

Members held discussion on the information and raised the following questions/queries:-

- Members asked whether the Leaning Disability Partnership Board covered the Borough or wider Teesside area. Members were informed that it covered the Stockton area. Members stated that it would be a great source of information and added that it was encouraging to see that the Board was co-chaired by people with learning disabilities.

- Members asked whether there was sufficient provision of A Safer Place, and asked if there was any action that could be taken to increase awareness of A Safer Place, and where they were. Officers stated that more detailed information could be provided to Members subsequent to the meeting. It was noted that places with a clearly defined reception had been found to be most effective in a small ‘mystery shopper’ exercise, whereas the experience with transport and shops without a clear point for customer service was more variable.

- Members asked for further information about the Council's membership of Inclusion North. Officers stated that the Council paid a subscription to access bespoke provision and was a valuable resource. Work included consultation and engagement, and training for staff and clients.

- Members asked if Officers were able to provide data on access to general Council services for those with learning disabilities, and take up by people with learning disabilities. It was also suggested that the Committee make use of self-assessment audits, such as the ‘Green Light’ audit used in mental health services.

- Members stated that the Committee needed to consider people with learning disabilities in a holistic manner, rather than just considering issues around social care. The Committee wished to see research into the experiences of all people with learning disabilities, not just those who were engaged with social services. Members were interested in researching a range of services available and the attitudes of employers. Members expressed a wish to find examples of good and bad practice, which would inform future action.

- Members asked why the Health and Care Self-assessment Staying Healthy question 8:- complaints lead to change - was categorised as 'red' on the RAG scale. Officers stated that this was because the data could not be quantified robustly when the self-assessment was undertaken and that the default position had to be entered as ‘red’, and Officers informed Members that this was being followed up.

- A question was also raised about Staying Healthy Q6 (the referral system from General practitioner to acute services): officers informed Members that the detail behind this response would be circulated to the Committee following the meeting.

Members discussed the draft scope of the review and asked that the scope be amended to include the following:-

- Audit of the use of the Council's universal services by people with learning disabilities and autism.

- Further investigation of issues affecting communication within and between organisations that work with people with learning disabilities, particularly in relation to communication about the status of identification and recording that an adult has a learning disability in health care.
The Chair provided the Committee with an update.

Can't find it

Can't find what you're looking for? Let us know and we'll do our best to point you in the right direction