Item 9.5 for 4 Aug 09 Moray SC&CHP 20 March

APPROVED

MINUTE OF THE MORAY COMMUNITY HEALTH AND SOCIAL CARE PARTNERSHIP

FRIDAY 20 MARCH 2009

Eight Acres Hotel, Elgin

Present

Mrs B Bruce (Chair)NHS Grampian

Mr A Fowlie, General Manager MCHSCP

Mrs J Mackie, LSM Social WorkThe Moray Council

Mr S Coady, LSM – NursingMCHSCP

Mrs T Gervaise, Public Health LeadMCHSCP

Mrs I Graham, LSM - AcuteMCHSCP

Miss P Freeland, Community Representative MCHSCP

Dr B Welsh, Clinical LeadMCHSCP

Councillor L Bell The Moray Council

Councillor John SharpThe Moray Council

Mrs E Bush, Director MVSOMCHSCP

Mrs M Nelson Optometrist

Mrs S Bruce, Community RepresentativeMCHSCP

Ms D Bosworth, Finance OfficerThe Moray Council

Ms B Aitken, Endoscopy Nurse PractitionerMCHSCP

Mr J Carney, Head of Children & FamiliesThe Moray Council

In Attendance

Mr K Hamilton, Business Manager; Mr A Pilkington, General Manager Combined Child Health; Mrs F Powell, Minuting Secretary and Liz Tait, Clinical Governance Coordinator

Apologies

Apologies for absence were intimated on behalf of Councillor A Macdonald; Councillor J Hamilton; Mr G Smart, General Dental Practitioner; Mr M Roos, Associate Medical Director; Mr S Riddell, Director of Community Services; Ms G Grant, Pharmacist; Mrs S Chisholm, Head of Community Care; Mr B Sivewright, Finance Manager; Mrs A Slee, Integrated Learning Disability Manager; Mrs E Brown, Service Planning Lead; Ms J Stewart, Chief Housing Officer; Mr M Perera, Integrated Mental Health Manager; Mr R Donald, Acting Head of Educational Support; Councillor A McKay, Ms M McCallum; Acting Chief Officer Volunteer Centre Moray; Ms Anne Cheyne, Community Occupational Therapist, Mr A Reid, Scottish Ambulance Service; Mr P McLean, Sector Lead Moray Health Intelligence.

Welcome

The Chair welcomed the group to the CHSCP Meeting.

Minute of the Moray Community Health and Social Care Partnership Dated
12 December 2008

The Minute of the meeting of the Moray Community Health and Social Care Partnership and Workshop dated 12 December 2008 was submitted and approved as an accurate record of the meeting.

Matters Arising

ATOS

Work has begun in Aberdeen. Progress will be reported to a future meeting.

Commissioning Services

Work on the Commissioning Plan has been delayed. The Performance Plan drives the priorities for the year and the Clinical Strategy will form the future Commissioning Plan.

Performance

Please see attached balanced scorecard and traffic light system. This is used to assess health and social care service performance and highlight risks to be addressed.

Planned Care

Targets for planned health care and the target for outpatients have been attained. The cancer target has been met one hundred percent over the previous two months. Cataract surgery and cardiology targets are being attained. Orthopaedics has had a particularly challenging winter, but is now meeting all obligations.

Unscheduled Care

Creates most pressure on health and social care services. Work will be done with ATOS to identify ways of improving Accident and Emergency waiting times and reducing the length of stay in hospitals.

Commissioning Services

Steady progress is being made in recruiting to the Challenging Behaviour project in Forres. Carers services have been transferred to a new service provider. The recruitment of specialist staff, e.g. radiologists remains a challenge due to international shortages.

Care in the Community

Steady progress being made. The retention of homecare staff in the Keith/Speyside area remains a challenge. Length of stay in community hospitals is higher than the norm. A review will be carried out with ATOS to assess how the situation might best be addressed.

Self Care/Inequalities

Dentistry – Work has begun on the new Elgin facility, which will provide training as well as treatment. The number of NHS dentists in Moray has increased by seven between 2007 and 2009. It is intended to recruit a further ten dentists during 2009 to enable expansion of the service. Four dentists have already been recruited.

Technology

A proposal for the progression of telecare/telehealth and e-health/care will be taken forward in April 2009.

Workforce

Additional support being offered on stress, anxiety and depression.

Standards

Positive feedback has been received on the learning disabilities inspection.

Infrastructure

A new CT scanner will be installed in Dr Gray’s Hospital.

Finance

Dr Gray’s Hospital still shows an overspend, as does learning disabilities. Mental health and addictions shows an underspend. Older people has a large underspend resulting from ring-fenced spend for telecare. Administration costs for Moray Council also show an underspend, resulting primarily from a delay in spending adult protection funding. The financial forecast expects an overspend of £1 million. This is currently estimated as standing at £0.5 million. The following year will be a challenging one.

HMIe Child Protection Inspection

The inspection of services to protect children in the Moray council area took place between June and September 2008. It covered the range of services and staff working in the area who had a role in protecting children. These included services provided by health, the police, the local authority and the Scottish Children’s reporter Administration (SCRA), as well as those provided by voluntary and independent organisations. The inspection showed overall unsatisfactory performance in child protection services. Many improvements have already been put in place. A multi-agency action plan has been developed and will be submitted to HMIe on 9 April 2009. An updated action plan and evidence of improvements made will be submitted in June, with a further inspection to take place in November 2009.

A Clinical Care Strategy for MCHSCP

A Fowlie delivered a presentation on the Moray CHSCP, its purpose, its commitments to its clients, its challenges: clinical; performance and budget. The two major issues for clinical and care strategy over the next 10 years are demographics and hospital design service. A draft strategy has been formulated to address these issues. A formal consultation on the document will begin in April 2009 and continue over a two month period and will include a consultation event. The final draft will be prepared in June 2009 and will be brought back to Committee.

Elaine Brown, Service Planning Lead will lead the consultation following Scottish Health Council methodology. A Public Involvement Officer has just been appointed and will link with local community planning forums. It is important to capture the public’s perception, ideas and experience and to enable people to continue to be carers and contribute to the workforce.

Single Outcome Agreement

The Single Outcome Agreement (SOA) is a public statement of the joint commitment and mutual accountability of the Scottish Government and Community Planning Partners to deliver agreed outcomes. The SOA brings a new approach to partnership working which focuses on the delivery of five strategic objectives: healthier; wealthier and fairer; safer and stronger; greener and smarter. MCHSCP will be making a significant contribution to the SOA during 2009/10. It is recognised that by working together, public services and the Scottish Government can ensure a greater focus on the jointly agreed priorities. It is likely that funding will be based on the priorities set out in the SOA. The following have been identified as priorities for health and social care in Moray: health improvement; caring for the elderly; reducing the impact of alcohol; mental health.

Items for Noting

The minute of the Performance Governance Committee (22nd January 2009) was tabled for information. The CHSCP Committee reports to this group.

The Health and Well Being Profile 2008 for Moray was tabled for noting along with an update prepared by local health intelligence. Local evidence suggests that high recorded prevalence of obesity and diabetes mean that life expectancy may not be better in Moray. The 2008 profile suggests that prescribing rates for anti-depressants in Moray are double the Scottish average and they also suggest that via their traffic light system that this is better than the Scottish average, this is a significant drain on the prescribing budget and financial resources. The profile of smokers in Moray shows that there is significant variation in locality rates. Multiple hospital emergency admissions are significantly better than Scottish average, yet there are four hour target pressures at A&E Departments Moray-wide particularly over the winter period. The Scottish Public Health Observatory (ScotPHO) updates profiles on a three yearly cycle.

AOCB

Dr Berny Welsh – Andrew Fowlie announced that Dr Berny Welsh had completed his three year term as Clinical Lead. His contribution and practical method of thinking have been much appreciated. He was wished every success in his new post at Seafield Hospital, Buckie.

Dr Jamie Hogg will take up his appointment as Clinical Lead in April 2009.

Mrs Mary Nelson – Andrew Fowlie extended thanks to Mrs Mary Nelson for her contribution to Moray CHSCP. She is standing down from the Committee. Lloyd Griffiths will take her place on the Committee.

Mrs Barbara Bruce – Andrew Fowlie announced that Barbara Bruce was standing down from the NHS Grampian Board and Chair of Moray CHSCP after a period of 10 years and many years previously with Highland Health Board. Moray has been extremely fortunate to have had such an experienced Chair. On behalf of the Committee, Andrew Fowlie extended thanks for the work Barbara has done for the betterment of the population of Moray. The new Chair will be appointed in June 2009.

Date of Next Meeting

The next meeting of the CHSCP Committee will take place on 19th June 2009, 10:00am, in the Eight Acres Hotel, Elgin.