Agenda and minutes

Apologies were received from Cllr Mrs Cornes, Cllr Mrs Hailstones, Cllr Mrs Johnson and Cllr J. Taylor.

Councillor Loades declared an interest in the agenda items referring to his involvement with Healthwatch, Staffordshire LINk and the UHNS Supervisors Board.

RESOLVED:              That the minutes of the meeting of the Committee held on 9 January 2013 be agreed as a correct record.

The Committee received a presentation from Lesley Russell, outlining her role as Chief Dietician in supporting nutrition at the University Hospital of North Staffordshire (UHNS). The Chair explained that Members had concerns regarding feedback and complaints that had been received about food at the hospital, and requested a general overview.

Dieticians were employed at UHNS according to their different specialities and the hospital had a nutrition policy with three key elements. The first was nutrition screening, where the risk of malnutrition was documented and the progress of patients could be tracked. Some patients were malnourished when they entered the hospital, with 30% of patients at risk when admitted. The second element was ensuring the food provided was of the right nature and the correct menus were provided. Since the trust had become a Private Finance Initiative (PFI) Trust with PFI caterers more attention had been paid to the catering service. Sodexo managed the contract, with their food manufacturing business Tillery Valley provided the catering service. The third element of the nutrition policy dealt with food not being suitable for some patients, e.g. for patients who required tube feeding. A lot of work had been undertaken by the hospital in tasting food etc. There had been problems initially, for example when the mashed potato provided was different from that given at tastings. However, there had been a lot of hard work over the years to improve the situation.

The dieticians had a lot of input into the menus at the hospital, which was important. The dietician’s biggest triumph was to introduce a hot choice for both lunch and dinner, with an increase in the range of menus. There had been three different systems before, which had been difficult to manage. All meals were cook/freeze now which was better for storage, and there were a la carte menus. Members questioned whether meals could be freshly cooked on site if required. They could be if requested, but large numbers of meals were not prepared on site due to the large volumes of patients. The screening process for nutrition was questioned and whether this was dependent upon the information provided by patients. It was objective and would depend upon BMI, the acute disease score, whether there had been recent weight loss etc. Screening would not be provided for palliative patients or for patients who refused to be subject to screening. Patients with multiple allergies would be monitored by an alert system, which would be communicated to the caterers by hospital staff if they were aware of a patient having allergies. The hospital also had an allergy menu. Wards could refer patients if they were having difficulties with a patient not eating, there were guidelines to follow and food assessment charts. A ward should pick up if there were problems with a patient’s eating habits.

Members of the Committee were interested in food waste at the hospital; the percentage of food that was supplied and not eaten and whether any food was recycled. The catering  ...  view the full minutes text for item 4.

The Committee received Dr M. Shapley (Clinical Chair) and Dr D. Hughes (Clinical Accountable Officer) to discuss the role of the North Staffordshire Clinical Commissioning Group (CCG). The Chair emphasised that the Committee would like to see closer links with the CCG and to work together rather than focusing on financial aspects. Newcastle Borough Council had their own initiatives, but were very keen to see preventative measures.

In April 2011 the CCG was delegated an authority and would be designated an authority in April 2013. The upcoming months were very important and there would be public meetings of the board. The CCG was poised to get through 2013 well, with 80% of services commissioning and were also in a good position as they had come from a single Primary Care Trust (PCT), and had retained good staff and skills. The PCT had 158 full time staff; the CCG had 38 and was much smaller. This had been mitigated to some extent by PCT staff working in the commissioning support unit, e.g. in HR. The CCG aimed to be lean and nimble, but there was quite a challenge ahead. The Doctors felt the CCG was significantly leaner and working very hard. 

Members questioned what services were being commissioned by the CCG as a commissioning body. The system had changed dramatically in 2012, with the Director of Public Health having accountability and the CCG taking responsibility for meeting targets. The CCG did not commission areas coming under general practice, such as sexual health, but were able to purchase some aspects of preventative care and could commission certain services if required. However, the primary accountability was with Public Health. With regard to community services provided by the hospital, Members felt an understanding of the health requirements of North Staffordshire was needed. Through the Joint Strategic Needs Assessment, there was a good idea of what was happening in different areas and this would influence what services it was felt needed to be commissioned.

The responsibility for walk-in centres was questioned by Members. As the NHS had changed dramatically, Members felt a road map of how the NHS worked was required. The CCG had inherited the walk-in centres and it was advised that there was an on-going review. The Staffordshire and Stoke on Trent Partnership NHS Trust (SSOTP) were responsible for the Haywood walk-in centre, which was an important centre and worked well with A and E. Some walk-in centres were the responsibility of the CCG, and there were CCG staff employed at the Haywood centre. This was not considered positively by Members. Members noted that the purpose of the walk-in centres was to see patients who would have otherwise gone to A and E, and had personally experienced visiting Morston House and not being able to see a doctor as it was necessary to be registered at the centre. A few years ago an appointment could be obtained within one hour, but it appeared that the centre was now operating more like a GP  ...  view the full minutes text for item 5.

The Chair advised the Committee that the visit to the Accident and Emergency department at UHNS would take place on Tuesday 5 March 2013 between 1pm and 4pm. Further relevant information would be communicated before the visit.

RESOLVED:              That the information be received.

The Committee considered and discussed their work plan. It was questioned whether there had been any communication about the financial position of Combined Healthcare, which there had not been. This would be chased up the next working day by the Chair and Scrutiny Officer.

There was a request that the parking problems being experienced at UHNS be added to the work programme. Members felt that parking was becoming a big issue and that people were parking in the town ward due to the parking problems. The Committee would like to know what was being done to address the problem. The Interim Chief Executive for UHNS would be invited to the next meeting of the Committee in April. Members did feel that it would be beneficial to invite UHNS officers with specific knowledge of the areas the Committee were concerned with.  

There was discussion of the Mid-Stafford Report and the thirty pages concerned with the activities of the Borough and Staffordshire County Council Overview and Scrutiny Committees. The County Council had made significant improvements with such things as the accountability sessions, but had come out badly in the report as not providing officer support and that health knowledge and officer time were not provided. Members felt that this section of the report should be studied and thought given as to whether Newcastle Borough Council would have been in the same position as the County Council. It was agreed that a review of the report would be included in the work plan, with the Committee then providing a report for consideration to Cabinet, EMT and the Co-ordinating Committee. The Committee felt that they should work out where Newcastle would have been deficient if the situation had happened here. Councillor Loades would take this away as part of his LINk work and bring back what objectives other people were looking at to the next meeting.

With regard to the accountability sessions, the Committee noted that they needed to give thought to the questions asked at these sessions to ensure the right questions were asked and to ensure they spoke to each other well in advance of the sessions to discuss what they wanted to ask. Members concurred that they needed to be more prepared and demanding and if a sufficient answer was not provided they would not let it lie. Members questioned whether there was a pre-meeting for the accountability session. The Portfolio Holder for Stronger and Active Neighbourhoods advised that difficulty may arise from the fact that the Committee was a sub-committee of the county Health Scrutiny Committee. It might be necessary to negotiate with the County Council to attend, but that as Newcastle Borough was on the doorstep of UHNS, the Borough Council would be well placed to attend. It was noted that the Council did not have a solely dedicated resource for the issue, although there were a number of officers in public health roles. It was also noted that the County Council had reduced officer support, and so were  ...  view the full minutes text for item 7.

There was no urgent business considered.