Stockton-on-Tees Borough Council

Big plans, bright future

Adult Services and Health Select Committee Minutes

Thursday, 30th October, 2014
Community Zone, Northshore Academy, Talbot Street, Stockton-on-Tees, TS20 2AY
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Mohammed Javed(Chairman), Cllr Kevin Faulks(Vice-Chairman), Cllr Evaline Cunningham, Cllr Ray McCall, Cllr Mrs Sylvia Walmsley, Cllr Norma Wilburn, Cllr Mrs Mary Womphrey.
Keith Hobbs, Mick McLone(DNS), Liz Hanley, Angela Connor, Janet Ballinger, Heather Glitherow(CESC), Emma Champley(Public Health), Peter Mennear and Kirsty Wannop(LDS)
In Attendance:
Sheila Lister and Denise Jones(NHS England)
Apologies for absence:
Cllr Paul Baker, Cllr Elliot Kennedy and Deborah Miller.
Item Description Decision
AGREED that the minutes of the meetings held on 16th September 2014 and 23rd September 2014 be approved subject to the above.
AGREED that the information be noted.
AGREED that the information be noted.
AGREED that the information be noted.
AGREED that an additional meeting date be identified and North Tees Foundation Trust and the Clinical Commissioning Group be invited to provide an update on the future of the Momentum Programme.


Cllr Mohammed Javed declared a disclosable pecuniary interest as he was employed by Tees, Esk and Wear Valleys NHS Foundation Trust. Cllr Javed had been granted a dispensation in this regard.

Cllr Ray McCall declared a personal interest as he was an Associate Hospital Manager for Tees, Esk and Wear Valleys NHS Foundation Trust and a Member on New Horizons Teesside.
Consideration was given to the minutes of the meetings held on 16th September 2014 and 23rd September 2014.

Members agreed that the minutes should be approved subject to the below addition in the 16th September 2014 minutes, at the item titled Healthwatch Stockton-on-Tees Annual Report:-
- Members commented on the need for Healthwatch to ensure future Annual Reports were checked for consistency and accuracies, as the latest version contained a number of errors.
The Committee were provided with an update regards the Review of APMS GP Contract at Stockton Health Centre. Members had received a briefing at their meeting on 23rd September 2014 regarding the consultation process that was open until 29th September 2014. Representatives from NHS England were in attendance and outlined the new proposals following the consultation process.

The consultation had found that:
- The practice served a population with a high degree of need
- There had been issues relating to the access to primary care services across Stockton-on-Tees which people felt may be detrimentally affected by any significant changes to the provision at Stockton Health Centre.
- Decisions on the registered element of the service needed to be taken in the context of the provision of the “walk-in” service operating out of the practice.

In light of the findings, NHS England was proposing the following as the way forward for this contract. NHS England would:
- Look to extend the current contract of the practice until 31/3/2016
- Enter into a joint piece of work with Hartlepool And Stockton Clinical Commissioning Group and Stockton-on-Tees Borough Council public health team to jointly undertake further work on the needs of the patients registered at the practice and the interdependencies between the registered and walk-in elements of the service at the practice
- Jointly develop a set of proposals for a sustainable solution for a service for the patients, re-consulting of these proposals at a later date if necessary.

Members requested that consideration was given to reducing the cost of the Practice as part of the future work, together with the benefits of the current extended access open times.

NHS England noted that the APMS service currently in place cost £89.02 per patient and GMS was £73.56. This was something that needed to be considered when Reviewing the contract. The Practice had a relatively small patient list and it was important that future arrangements were viable.

It was confirmed that all options would be looked at.

The Committee welcomed the proposal to extend the contract and it allowed time to review it further with all the necessary people.
The Committee considered information provided on in relation to the assessment process, arrangement of care packages and personalisation. The main information provided included:-
- Referrals for Home Care could be made from anyone and a social worker would be allocated to undertake the assessment process. There was a standard assessment to identify individual eligible needs. If it was decided from the assessment that Home Care was needed, the care package would be arranged with one of the commissioned providers who would visit and undertake a further assessment to organise the details of the care package.
- Every client would also be given the option of a direct payment to arrange the services of a Personal Assistant(PA). The use of the direct payment, in terms of whether the client’s needs are being met, is subject to monitoring by the client’s social worker. There was an in house support service for those receiving a direct payment to provide support and advice and to help with administration and payroll requirements.

Members made the following points/comments/questions:-
- What did the 15 minute calls cover? It was explained that this did not include any personal care and was more of a welfare call. It was noted that the provider would be paid for 20 minutes to help to address the relatively longer travel time associated with shorter calls.
- If a carer arrived and the client was ill they would stay with the client until medical help was secured and procedures were in place with the providers to ensure that carer’s other calls were covered.
- What checks were in place to ensure carers were staying for the correct time to carry out the care packages in place? Providers had to have a call log system in place that was monitored by Commissioners. There were various types of automated systems available which needed to meet contractual requirements.
- When a client was receiving direct payments and became an employer what support was in place to help? Members were informed that the Council had support in place to help those wanting to use direct payments i.e. recruitment, HMRC, advice and training. It was also noted that it was ultimately up to the client and they did not have to employ somebody who was suitably qualified, (this could happen in cases where family members or close friends were going to provide the care). The Local Authority offered free access to training.
- The average wage paid using direct payments was £7.50 per hour, and the local authority provided £9 per hour, including funding for contingencies. Additional funding may be available if needs are particularly complex.

- If a client lacked mental health capacity to become the employer, a ‘suitable person’ such as a family member could be identified to manage the direct payment. They would then be monitored by the Local Authority and registered with HMRC.

The Committee was then provided with information on the assistive technology that was in place to help people remain independent in their homes. The main information included:-
- There was over 7000 service users of Care Call and 5500 pieces of equipment. 2500 users were private self-funders.
- The service received 10,000 calls per month; 98% were answered within 1 minute. Some of these were ‘welfare’ calls that could be resolved over the phone, and others required a response to the home. 97% of call outs were attended within 30 minutes
- Demonstration of some of the equipment and details of how it worked was provided.

Members made the following points/comments/questions:
- How much did the equipment cost? It was explained that the ‘basic’ care call box and button than linked to the telephone system that the other devices could be linked up to cost £3.70+VAT per week. There was an all inclusive package available that cost £11.94 per week.
- If clients were eligible for a full care package, the cost of the assistive technology was taken into account as part of the full financial assessment.
- Was the service provided in care homes? Members were informed that assistive technology was now operating in a pilot of some care homes, using pager systems to alert the on-site carers. Since it was installed there had been a reduction in falls, although further evaluation of this was needed. This had been funded via one-off Reablement funding.
Member considered an update on the work of the Tees Valley and Regional Joint Health Scrutiny Committee.

On 11th September the Tees Valley Joint Health Scrutiny Committee considered additional monitoring of the North East Ambulance Service on a sub-regional basis, and a briefing on the future of in-patient Haematology Services at North Tees and Hartlepool NHS Foundation Trust.

The next meeting was on 27 November, and this would include an update from North East Ambulance Service (NEAS), as part of the additional monitoring of NEAS performance at sub-regional level in line with the Committee’s recommendations. The 2014/15 work programme was provided.

The Regional Joint Committee met 29th September 2014. The meeting covered:
- The consultation as part of the national review of services for congenital heart disease (nb. consultation ends on 8 December);
- Quality and Performance Update from NEAS;
- Patient Transport Criteria;
- Update on the work of the Northern Clinical Senate.

The Regional Committee had arranged a further meeting with the Clinical Senate for 20 November to discuss the overall vision for acute health services in the region.
The Committee considered its work programme and it was noted that at the next meeting consideration would be given to the North Tees and Hartlepool NHS Foundation Trust Quality Account. Members requested specific information regarding the following:-
- Summary Hospital rates.
- Cancer Referral to Treatment Times
- Staff survey results
The Chair requested that the Trust be called to a meeting to discuss the suspension on the work on the new hospital. Due to the Committee's work programme it was noted it may be necessary to arrange an additional meeting date to consider it.

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