Minutes of Healthwatch Sefton Steering Group meeting
Held Wednesday 31st May 2017. 10:30 – 12:30
Southport Centre for the Deaf. 19a Stanley Street. Southport.
PR9 0BY
ATTENDEES:
Chair Maureen Kelly (MK)
Organisational Representatives:
John Black (JB) Southport and Formby Community Champion
Network
Ann Taylor (AT)Every Child Matters Forum
Sue Evans (SE)Health & Social Care Forum
Tony Haigh (TH)Sefton Carers Action Group
Locality Representatives:
Anne Major (AM)Central Southport
Nigel Booth (NB)Formby
Ken Lowe (KL)Ainsdale & Birkdale
Brian Clark (BC)North Southport/ Vice Chair (Steering Group)
Diane Foulston (DF)Crosby (Inc. Waterloo, Thornton and Hightown)
Maurice Byrne (MB)Maghull
Staff:
Diane Blair (DB)Manager
Wendy Andersen (WA)Engagement & Participation Manager
Betty Boner (BB)Engagement & Participation Officer
Guest Speaker:
Andy Gilbert (AG)Knowsley Disability Concern.
APOLOGIES:
Organisational Representatives:
David Skelton (DS)Sefton Equalities Partnership
Jessie Taylor (JT)Sefton Young Advisors
Shannon Bryan (SB)Sefton Young Advisors
Roger Hutchings (RH)Co-opted member
Marion Hepworth (MH)Sefton Partnership for Older Citizens
Locality Representatives:
Sarah OldnallBootle
- Welcome, introductions & apologies
MK welcomed all members. Introductions were made.
- Declaration of Interests (in line with agenda items or changes), including Code of Conduct reminder.
MB informed members that he would be acting as an agent for a candidate in the local elections.
- Minutes from previous meeting.
Minutes from the meeting which took place26th April 2017 were agreed as an accurate record with the following amendment; page 1 Anne Major (AT) to be changed to Anne Major (AM).
- An overview of Personal Budgets. Andy Gilbert (AG). Knowsley Disability Concern.
AG introduced himself and provided an overview of Knowsley Disability Concern, which is a Knowsley based charity, set up 20 years ago. AG is the team manager for the ‘Direct Payment Support Service’ and has worked there for 9 years.
Personal Health Budgets (PHB) has grown from budgets used in Adult Social Care. PHB were piloted and have now been adopted across the country. In April 2015, it was introduced that a personal health budget could be used if an individual was eligible for 100% Continuing Health Care (CHC).There are variations to this and it depends on the local offer of each Clinical Commissioning Group (CCG). NHS England anticipated that each CCG would have its own offer and there had been a grant available to areas so that they were ready for the local offer.
Support will be provided as follows;
a)Know the budget for care (how much your care will cost) upfront
b)Helped with putting together a support plan
c)Work with health professionals to put a budget in place
d)Support plan/ budget is signed off.
There are a number of ways a PHB can be set up;
a)You know your budget, you have a support plan with outcomes and the CCG hold the budget.
b)The above, with a third party holding the budget
c)Direct Payment – for example an organisation can support the family to make this happen, the individual/family become employers etc and the budget is handed over.
A number of case studies were shared by AG.
a)25 year old with significant health conditions was eligible for CHC and asked for a PHB. Previous experience of 3 different care agencies had been unsatisfactory. 2 overnight carers were required. Parents had not been happy not knowing who would be caring for their son as the turnover of staff was high. A PHB was created and a small team of core carers were employed. In the 18months that this was established, quality of life/ health care needs had improved and hospital admissions had reduced. The parents had increased satisfaction with services being provided and the individual had more choices and felt in control. £1000 less had been spent with this plan being in place.
b)60 year old male, undertook his own research and became more informed about PHB. KDC helped with the support plan and the indicative budget. The gentleman wanted the plan to support him from being admitted into a nursing home and prevent hospital admissions. He felt that his wife was the best person to care for him. A clear contingency plan was put in place in case his wife became ill or needed a break. He needed a clean house as he was vulnerable to MRSA and some of the budget was spent on cleaning which also helped to free his wife up to provide care. A personal assistant was also put in place to help with social needs, this helping the gentleman to get out and about, which also helped with psychological needs. This care was provided well within the budget which was allocated. Within the first 18 months of the plan being in place, there had been no admissions into hospital and he hadn’t been admitted into a nursing home. The gentleman was happier and was happy with the outcomes in his healthcare.
c)Young male during a night out was involved in an accident which resulted in him having a smashed skull. KDC helped with the practicalities of the budget and provided wrap around advice. With the support from the PHB, he was able to live independently in his own home and had a good recovery with rehabilitation. There was fantastic support from his parents and the support team in place.
All PHB are monitored locally by the CCG/ local authority. Locally progress is comparatively slower and the offer is narrow being restricted to CHC. CCGs are still getting to grips with the offer and what budgets can be spent on. There has been national coverage about what budgets have been spent on for example, SKY TV. What wasn’t covered was this had been bought for a patient with advanced Dementia. Day care centres were not working and putting on the patients favourite TV shows helped to avoid distress during the evening. It’s about looking differently.
KL asked a question about budgets and if there was a limit to budgets being allocated? There is no ceiling but CCGs will be equitable and transparent about what the individual budget will be. It is reasonable to look at what the cost of services would be if they were commissioning the service.
MB asked a question about eligibility and a further question was asked about how this differs then to social care where income is taken into account. AG reminded members that this is not new money; it’s about using the money differently. The CCG decide what the local offer is, and share this and local progress made to NHS England. This is separate from any welfare benefits individuals may be receiving. PHB does not affect personal benefits.
AT shared information how the local offer for SEND (special educational needs and disability services) needs to be reviewed. Work on the action plan to address local issues is currently on hold due to Purdah but it was agreed that Healthwatch Sefton review the plan when it is sent back.
SE felt that in her work environment, there are problems with CHC as individuals needs change and this impacts on the decisions made by the CHC team.
TH felt that Carers need to be supported as they often become an employer and it’s hard to cope with the financial issues. AG stated that Sefton Carers Centre is cited as a reference in the South Sefton CCG local offer.
AG spoke about the work KDC have been undertaking with Knowsley CCG to support work to fast track budgets for end of life patients who are in the last 6 months of their life. AG also attends a regional network and is looking at a city region network to be set up. The network will look at local offers and how to support CCGs stepping up their offers from CHC. AG gave out supporting information including; information from the South Sefton CCG website, PHB brochure from KDC and other supporting information from NHS England. AG was thanked for coming to talk to the group and left the meeting at this point. ACTION: To find out what support Sefton Carers Centre provide locally with PHB. To request an update from the CCGs which includes an overview and update on Continuing Health Care funding allocations over the past year, how many personal health budgets were put into place and at what level.
- Action Tracker Report (actions not on the agenda).
Page 1South Sefton CCG and NHS England Joint Commissioning Committee – MK confirmed that the Terms of Reference had been agreed at the last meeting of the CCG governing body and that a formal invitation would be sent to Healthwatch.
Aintree University Hospital – car park experience report – A response to all issues relating to Aintree will be sent back to Healthwatch by the deadline of 5th June. ACTION: update to be provided at the next meeting.
DNA at Glaucoma Clinics (Aintree) – WA has raised this at the patient experience group and an update will be sent when ready. ACTION: update to be provided at the next meeting.
Joint working, CCG merger – The OSC (Adult Social Care & Health) had held a special meeting (23rdMay, 2017) to discuss the plans with the CCG. Concerns about the paper which had been shared with Healthwatch were raised at the meeting as well as the lack of engagement with Healthwatch in the process. ACTION:formal update to be requested from the CCGs.
Hightown & Freshfield Surgery options appraisal task and finish group– due to Purdah there has been no more meetings of the group and Healthwatch has not been able to review the outcomes from the review and the surveys which were being completed on transport and the premises. ACTION: it was agreed that concerns be raised with NHS England about the pause and the lack of engagement.
Page 2Walton Centre Foundation Trust Governor – The opportunity has been circulated and the deadline is 13th June. Action:Update to be provided at the next meeting.
Authorised Representation – an updated diagram was shared with members.
Medicines Management Committee –Suzanne Lynch, Head of Medicines Management had contacted Healthwatch following the request for a seat and is looking to discuss better ways of Healthwatch receiving information. Action: DB to follow up and provide an update.
Recent fires at Scrap Metal yard – an update had been provided by Matt Ashton, Joint Director of Public Health (Knowsley / Sefton) and will be shared with the South & Central Sefton Community Champion Network.
Access to Community Equipment – this is being picked up by Southport & Formby Community Champion Network. Action: update to be provided when available.
Mersey Care Community Service Advisory Board – a meeting with Trish Bennett is being held 7.7.17 and DB will gain an update on the acquisition of community services and the advisory board. Action: update to be provided when available.
Ward transferred from Southport & Formby to Ormskirk –No update as yet. Action: update to be provided at the next meeting.
Page 3Listening Events – WA informed members that Liverpool had been informed that Sefton would not be taking part in future events. The draft report from Liverpool Women’s NHS Foundation Trust has yet to be received. ACTION: To request the report from Healthwatch Liverpool for the next meeting.
St Marks Medical Centre - BB updated the group on the one action relating to the review of appointments. The Practice isconstantly looking at ways of improving the appointment system and they have started this week to open the appointments for the whole day and make our triage system even more effective.ACTION: Monitoring and Scrutiny Panel to pick this up.
Audiology services from Specsavers – WA provided an update and it was agreed that a formal letter to Fiona Taylor, Southport & Formby and South Sefton CCGs be sent. AT raised the issue about children’s Audiology services and that they are no longer available at Southport & Ormskirk Hospital NHS Trust, the service now being provided from the main Alder Hey hospital site. ACTION: letter to be drafted and sent to Fiona Taylor.
Care at the Chemist – awaiting a response from the CCG about how the changes were shared with members of the public. ACTION: update to be provided at the next meeting.
Supporting Transgender Awareness–no progress has been made. ACTION: DB/JT to feedback at the next meeting.
Reduced Funding for mental health services - RH had raised this at the last meeting and DB shared the article which had been published on ‘Pulse Online’ ACTION: as there was no time to discuss this fully to be discussed at the next meeting.
Outstanding Actions
Page 4We Share because we Care leaflets – an update from Stephen Appleton, Head of Clinical Informatics had been shared with members. Members reviewed the response and agreed that this could be removed from the action log.
Retirement ages of GPs, Nurses and recruitment – Due to Purdah, Liz Thomas from Health Education England will be attending the June meeting to provide an overview.
Enter and View – Aintree University Hospital – Frailty and Rehab wards – assessments for bedside chairs –A response to all issues relating to Aintree will be sent back to Healthwatch by the deadline of 5th June. ACTION: update to be provided at the next meeting.
Page 5Patient Participation Groups –awaiting further information from NHS England. ACTION: update to be provided when available.
Procurement of specialist healthcare by clinical commissioning groups – DB informed members that she had been sent the web links to the financial commissioning spreadsheets which are available on a monthly basis and are available to the public. ACTION: More information about services commissioned by both CCGs to be requested at the next meeting of EPEG.
Issues with prescriptions for medication for Children/Young People – there has been no recent feedback.
- Work plan – a review.
DB handed out the refresh of the work plan which is now in an action plan format and includes all of the issues discussed at the last meeting. Due to time restrictions, members were asked to review the plan and it will be updated prior to the June meeting.
- Sustainability and Transformation Plan (STP) and other Pan Merseyside work.
Engagement on a single service for Orthopaedics has been on hold due to Purdah. Healthwatch has offered to hold an engagement event in South Sefton. In terms of wider STP work, it is still unclear about where Healthwatch should concentrate its efforts, the 2 CCGs working as part of the North Mersey footprint but Southport & Ormskirk Hospital NHS Trust as a service provider being placed within the footprint of ‘The Alliance’. It was agreed that an update on this is needed. ACTION: Karl McCluskey (Southport & Formby and South Sefton CCG) to be invited to the July meeting of the steering group. The presentation to include an update on finances.
- Communications Strategy
Members were asked for their comments on the draft strategy before it is approved by the Board in July. The following comments were made;
MK felt that the strategy needed to state how Healthwatch plans to communicate with hard to reach groups and people with disabilities. AM suggested that information be included about how we use ‘MeetingReports.’This might support the 1st Aim/Objective within the action plan. ACTION: DB to share comments with Louise Malone.
- Request for Representation.
A request from the local CCG to represent Healthwatch on the North Mersey Integrated Reablement and Assessment Service (ICRAS) Collaborative Implementation Group has been received. Members reviewed the draft version (2) of the Terms of Reference. Healthwatch has an open invitation to meetings. Members requested that a member of the staff team attend one of the meetings to get an overview of issues and discussions and that further information about the group and the North Mersey A & E Delivery board be requested. ACTION: DB to attend a future meeting of the group and request further information.
- Update from the Monitoring and Scrutiny Panel
BC provided an overview of the issues which the steering group was asked to consider;
- Joint letter to providers and commissioners about this years quality account process
- To use the guidance for NHS England and CCGs to help bring providers to account.
- Formal response requesting updates on action plans to be sent to Liverpool Community Health NHS Trust.
ACTION:Steering group considered the above and agreed that all issues should be progressed. MK thanked the panel for their work.
- Emerging issues and items for consideration – verbal.
a)South and Central Sefton Community Champion Network–WA provided an update. The network had received a presentation about the 111 service.