Agenda and minutes

To confirm the minutes from the previous meeting

The minutes of the previous meeting from 07 March 2018 were agreed by the Members present, however Edie Glatter’s name has been spelt incorrectly and therefore requires correction before the minutes can be signed off:

Action Point: Member Support to correct the spelling and forward the minutes to the Chair for sign off.

To receive any apologies for absence

Apologies for absence were submitted on behalf of Edie Glatter, Helen Brown, Cllr Timmis

Cllr Brown was not present.

To receive any declarations of interest

A member with a disclosable pecuniary interest or a personal interest in a matter who attends a meeting of the authority at which the matter is considered -

(i)            must disclose the interest at the start of the meeting or when the interest becomes apparent

and, if the interest is a disclosable pecuniary interest, or a personal interest which is also prejudicial

(ii)           may not participate in any discussion or vote on the matter (and must withdraw to the public seating area) unless they have been granted a dispensation.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Members’ Register of Interests, or is not the subject of a pending notification, must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal and prejudicial interests are defined in Part 2 of the Code of Conduct For Members

[If a member is in any doubt as to whether they have an interest which should be declared they should seek the advice of the Monitoring Officer before the start of the meeting]

There were no declarations of interest.

An opportunity for members of the public to make statements or ask questions in accordance with the rules as to public participation

There was no public participation.

The Actions points from the previous meeting were reviewed and agreed, outstanding action points are listed below along with the actions points added from the meeting held on June 202018.

Notes of the SOC Action Point

There was a meeting held this morning (20/06/18) to further discuss the Strategic Outline Case , there is still a piece of work to do on the Finance assumptions and activity modelling as well as what the new building will contain.

Work will continue through July and August with a view to involving public engagement in September. HVCCG would like to clarify this is not a formal consultation but more a way to gage what the public think of the plans.

Once discussion with the public has been completed and the information consolidated HVCCG would be looking at presenting to their Board in late December or January.

All Committee Members agree this is a very important issue which requires a special additional meeting in October to go over the findings.

After the presentation to the Committee a further presentation will be offered to outside Members.

Cllr England would like to ensure the additional meeting is timed so that the results of the Public engagement are available and can be shared with the Committee Members.

Action Point – HVCCG to advise Member Support when the Public Engagement is about to begin so that Members can be informed through Members News.

David Evans – Director of Commissioning, NHS Herts Valleys CCG to provide regular update.

David Evans provided the following Update to the Committee Members

Between January 31^st and March 28^th a Public Consultation was conducted regarding the opening hours of the Urgent Care Centre and the expiration of the current contract at the West Herts Medical Centre.

The results and outcomes are as follows:

Urgent Treatment Centre

For the past year the Urgent Treatment Centre has been running reduced hours from 8am to 10pm, part of the reason this decision was made was due to the staffing issues and the low number of people using the service over night (between 4 and 6 per night ).

The public were asked to give their preference from the following options:

Should the centre be open:   8am – 10pm

                                                8am – Midnight

                                                24hrs

The public’s preference was for the centre to remain open 24 hours a day.

However, taking into consideration the staffing issues, low demand and advice from clinicians a recommendation was put to the board for the centre to remain open from 8am – 10pm with a work force review scheduled to see if extended opening hours would be a possibility.

The out of hours 111 service is still available and gives a comprehensive assessment of each case via a trained professional, when required a house visit can be performed by an on call Doctor.

West Herts Medical Centre

The current GP Contract is about to expire, the options were to either retain a Duty Service or invite local practices to bid to use the surgery as branch of their existing practice,.

Following the Public Consultation and taking into account all the information a recommendation was given to the board that the Branch Surgery option would be the most beneficial.

It is unclear at the stage if it will be used as a branch for one or multiple surgeries, but more information will be known in October. 

Cllr Taylor acknowledges how difficult it is to make these decisions but understands why the recommendations were made.

Cllr Guest is disappointed that HVCCG were unable to deliver the 24hr service especially after the results of the public consultation.

Cllr Taylor asked for clarification regarding the services provided by the new Marlowes Health Centre. David Evans provided the following explanation:

The centre houses 2 main services, Hertfordshire Partners Foundation Trust & Hertfordshire Community Trust as well as Dentistry and the Child & Adolescent Mental health services.

Combining the services in the same building provides a more collaborative way of working and provides a more cohesive service for the community.

Action Point: Feedback on the survey for the times of Urgent Treatment Centre to be provided to the Committee Members.

Action Point: CCG workforce review follow up to be provided at the September meeting. 

Action Point: Urgent Treatment Centre feedback to be provided at the September meeting.

Action Point: HVCCG and Cllr Madden to liaise with Member Support regarding the October additional meeting to discuss the Strategic Outline Case.

Ted Maddex - Commissioning Manager, Integrated Community Support Team (Older People), Hertfordshire County Council to attend to provide update.

A presentation regarding the 2018 - 21 Carers Strategy was provided by Ted Maddex – Commissioning Manger, Adult Care Services HCC.

Hertfordshire County Council has had a Carer’s Strategy for many years, it is refreshed every 2 – 3 years, and the new strategy has just been launched.

The CCG and the Health Trust have their own strategies for dealing with carers but this is one of the places where they are linked to together through common strands.

Herts County Council provides 1.6 million pounds of funding to carers and organisations as well as additional specialist funding for people with disabilities and those with mental health issues.

In the 2011 census there were over 108,000 people nationally who identified themselves as carers, 14,800 of those are living in Dacorum, with similar figures being reported in neighbouring boroughs.

Encouraging people to register as a career is important so that they can access the various organisations which are there to provide advice and support.

The objectives of the new strategy are to enable carers to:

·         Carry on caring if they want to

·         To receive good quality information and advice when they need it

·         Be recognised, feel respected and heard as carers

·         Top have a life outside of caring, to access their local community and local services

·         To stay mentally and physically well

·         To be safe

·         Access full benefit and entitlements and financial advice

·         Receive consistent joined up services

This is a much more fluid strategy which will be review as it moves along.

A key part of the strategies success will depend on making sure the local services are mapped and made available for the carers in that area.

Cllr Taylor feels that item 7 “financial advice” is a welcome addition; through personal experience he feels this causes a great deal of stress and anxiety.

Cllr Maddern left the meeting 20.40

Cllr Hick and Cllr Howard feel the forms are very complicated and that people struggle with the online self-assessments, if someone was on hand to help with these issues it would make a huge difference.

Cllr Birnie issued a report to Members prior to the meeting and welcomes questions and comments.

NASCOT LAWN

The current provision does not appear to be working and there are a number of complaints from parent carers being received.

The recommendation by members was that the new service was in places before the closure however this seems to have been ignored.

PATIENT FLOW

In 2016 41 beds per day were tied up with people who had finished their health pathways but could not leave for one reason or another, this has been reduced to 27 per day in 2018 with the target set at 22.

Changes are being made and the service is improving, however The CEO is leaving Watford Hospital and this may cause some delays with further progress.

Cllr Guest provided the Members with a copy of The Carers Strategy for Hertfordshire: 2018

Work continues on the discharge plan and follows up care as well as detox strategies.

Cllr England questions where the money will come from after Brexit, Cllr Guest informs the Members that there will be no impact.

Cllr Birnie feels that Watford Hospital performed very well overall, especially communication, although there are issues on the clinical side these issues are being addressed.

Action Point: Step down care to be covered in the presentation in September.

Ward issues from other Councillors needs to be added as an ongoing agenda item.

GP Provision in Berkhamsted has been added to the agenda for September

Flexi care / Wrap around Provision will be moved back to December

There were no other items to be added to the work flow.

Action Point: Visit to the Health and wellbeing centre date to be confirmed – Member Support.