Agenda and minutes

Resolved: That all items be web-cast.

Apologies were received from Councillors Atwood and Mrs Stockell.

There were none.

There were none.

Resolved: That:

(a)  Councillor Elliott be elected Chairman for the municipal year 2010-11; and

(b)  Councillor Marchant be elected Vice Chairman for the municipal year 2010-11.

a) Disclosures of interest.

b) Disclosures of lobbying.

c) Disclosures of whipping.

a)  Disclosures of interest

Councillor Mortimer declared a personal interest in Agenda items 8 and 9 ‘Maidstone and Tunbridge Wells NHS Trust: Quality Report 2009/10’ and ‘Department of Health consultation on registering with a GP practice of your choice’ due to being employed in the Health care industry.

Councillor Cunningham declared a personal interest in Agenda item 8 ‘Maidstone and Tunbridge Wells NHS Trust: Quality Report 2009/10’ by virtue of his wife working for Hospitals in Maidstone and Tunbridge Wells.

Councillor Crowhurst declared a personal interest in Agenda item 8 ‘Maidstone and Tunbridge Wells NHS Trust: Quality Report 2009/10’ by virtue of the new Hospital at Pembury being in the Ward she represented.

b)  Disclosures of lobbying

There were none.

c)  Disclosures of whipping

There were none

Resolved: That all items be taken in public as proposed.

Interview with:

·  Glenn Douglas, Chief Executive;

·  Claire Roberts, Head of Quality; and 

·  Darren Yates, Head of Communications

Kat Hicks, Overview and Scrutiny Officer, introduced witnesses from the Maidstone and Tunbridge Wells NHS Trust :

·  Glenn Douglas, Chief Executive

·  Claire Roberts, Head of Quality; and

·  Darren Yates, Head of Communications

Mr Douglas described the progress the Trust had made in a variety of different areas over the year and responded to Members’ questions. It was explained that the publishing of Quality Accounts was a new process to the NHS. They set out the previous years performance and how the Trust will be judged over the coming year, and he welcomed input and feedback from the Committee on the progress made by the Trust.  The Trust had achieved the majority of its targets in 2009/10, and 90% of patients in all specialities had been treated within 18 weeks of referral.  Financially, in 2010 the Trust had balanced its budget for the second year in a row for the first time since 2001.

Mr Douglas said there had been a significant fall in Clostridium difficile (‘C diff’) infections in the Trust’s Hospitals, which now had the lowest rates in the Strategic Health Authority’s area. He explained the statistics for C diff infections included patients who were already infected at the time of admission. Although the overall number of cases for the year was low, there had been a sharp rise in the recorded number of patients with C diff throughout the winter. He attributed this to the high incidence of patients presenting with other viruses, such as the norovirus. During that period the hospital had tested all patients for infections on admission, leading to an increase in the number of recorded C Diff infections.

Mr Douglas said the rate of hospital acquired infection was very low. The Trust now routinely tested all patients for infection at the time of admission and would investigate whether they could set a separate target for hospital acquired infections. He added a survey of over 500 patients this year had shown that 95% of Hospital staff were using hand-cleaning gels before coming into contact with patients. The Committee was informed that the LINks report on infection control had found the Trust to be the best in Kent. But there were problems relating to hand hygiene at the entrance to the Pembury and Kent and Sussex Hospitals, partly due to the multiple entrances. Hand hygiene at the entrance to the wards was very good in all locations. He confirmed the Trust would issue a formal response to the LINks report.

Mr Douglas explained that, of the 23 cases of MRSA bacteraemia infection, 16 were acquired in hospital. Analysis had identified poor sampling procedures, resulting in cross contamination creating false positives, as a cause for the some of those cases.  The Trust had introduced new procedures and training to address this and expected the rates to reduce in 2010/11. He stressed that, although the actual number of MRSA infections was quite small, it was important to eradicate avoidable hospital acquired infection. There had only been one  ...  view the full minutes text for item 8.

Les Smith, Overview and Scrutiny Officer, explained the background to the consultation document and the options identified in the document for patients to register with a GP practice of their choice. The Committee then discussed the document.

A Member informed the Committee he had discussed the document with a semi-retired GP, who had suggested the proposals were driven by politics rather than a clinical need for change. He said the GP had not seen a need to change the current system.

Members noted that continuity of care was important. They considered that the more services were fragmented, the more difficult it would be to properly treat the individual. They believed that most people would prefer to be treated by their local GP, who knew their history. A Member said that many GP practices offer some evening and / or Saturday morning appointments to cater for those who found it difficult to see the Doctor during normal working hours.

Members discussed the suggestion, in paragraph 2.12 of the consultation document, that a patient’s record of home visits might be taken into account when considering which practice to register with. The Committee noted that a home visit might be required at any time and concluded all practices should assume that home visits would be required.

Members noted the proposal to introduce new ways of defining practice boundaries. They believed the current system worked well and saw no need to make significant changes. They were concerned at the disclosure in paragraph 3.3 of the document, that over 800 practices are believed to have closed their lists to new patients without having first agreed this with the PCT. The Committee considered this reduced the choice that patients currently have in their choice of GP practice. Members noted that the PCT already had powers to deal with such practices and believed those powers should be used.

Members noted that both options A and B had a significant weakness in that a Doctor conducting a home visit for an out of area patient would not have access to their health information until the ‘Summary Care Record’ was in place. Members believed that a Doctor should have full access to a patient’s history when treating and were concerned that a summary may cause confusion. They were also concerned that the Summary Record could be insecure and increase the risk of patient’s data being lost, particularly if accessed through portable devices.

Members concluded that, for the majority of people, the current system of registering with a local GP worked well and provided continuity of health care. They recognised that for some people, the ability to register with a practice some distance away, for example close to where they worked, would give them better access to GP services. They noted the weaknesses identified in the document relating to dual registration, but concluded that this provided the best way of meeting that need.

The Committee concluded that a response should be sent to the Department of Health confirming that dual  ...  view the full minutes text for item 9.

The protocol for Joint Committees as agreed by the Scrutiny Chairmen at Tunbridge Wells and Maidstone in 2007 is attached for noting. The Kent protocols for National Health Service Overview and Scrutiny are also attached for information.

The Committee discussed the protocol for joint committees between Maidstone and Tunbridge Wells Borough Councils. Members agreed that the Chairman should be elected on the basis of being the best person for the job and voted in on an annual basis. Members also agreed that all Members of the Committee should have voting rights; that experts could be co-opted onto the Committee; and that due to the specialised nature of the Committee substitute Members would not be permitted to attend Meetings.

The Committee also considered the Kent protocols for National Health Service Overview and Scrutiny and agreed that they were in need of review. Members also noted that the protocol prevented Overview and Scrutiny Committees adversely commenting on any individual officer of an authority or NHS body by name and therefore unduly restricted the role of the Committee.

Resolved: That the Committee would adopt the Joint Working Protocol on page 89 of the agenda with the following provisions:

a)  The Chairman be voted in on an annual basis;

b)  Substitute Members would not be permitted to attend; and

c)  Experts could be co-opted on to the Committee to help with reviews.

The Committee was informed that the only item currently on the Forward Work Programme was a meeting with the MP for Tunbridge Wells, Greg Clark and the Primary care Trust to discuss the recent Mental Health Care Provision Review. This was expected to take place on 16 July, but the Committee would be informed as soon as a date was confirmed.

Resolved: That the Forward Work Programme be noted.

2:24 p.m. to 4:20 p.m.[aw1]