Manchester City Council

Agenda and minutes

Agenda and minutes

Health Scrutiny Committee
Tuesday, 8th January, 2019 10.00 am

Venue: Council Antechamber, Level 2, Town Hall Extension

Contact: Lee Walker 

Webcast: View the webcast

Items
No. Item

1.

Minutes pdf icon PDF 158 KB

To approve as a correct record the minutes of the meeting held on 4 December 2018 .

Additional documents:

Minutes:

The minutes of the meeting held on 4 December 2018 were submitted for approval. Cllr Holt requested that her attendance be recorded.

 

Decision

 

To approve the minutes of the meeting held on 4 December 2018 as a correct record subject to the above amendment.

 

2.

Adult Diabetes pdf icon PDF 630 KB

Report of Dr Manisha Kumar, Clinical Director, Manchester Health and Care Commissioning

 

This report provides the Committee with an update on the activities to reduce inequalities in diabetes care and outcomes for the people of Manchester.

Additional documents:

Minutes:

The Committee considered a report of the Clinical Director, Manchester Health and Care Commissioning (MHCC) that provided an update on the diabetes work programme that had been designed to reduce inequalities in diabetes care and outcomes for the people of Manchester. The main aim was to improve the health outcomes and quality of life for all those at risk of, or living with diabetes in Manchester, through supported self-management, personalisation and early optimal interventions.

 

The Clinical Director MHCC referred to the main points of the report which were: -

·                Providing a description of the different types of diabetes and the implications of this condition;

·                Describing the prevalence of diabetes in Manchester, providing comparisons against Greater Manchester and England figures;

·                Projected figures for the number of cases of diabetes, noting that Manchester’s expected diabetes prevalence rates were set to increase;

·                Information on The National Diabetes Prevention Programme, an ongoing national programme which began in 2016 and was rolled out in Manchester in August 2017;

·                Data on the diagnosis of diabetes, with particular reference to NHS Health Checks that helped to identify people with diabetes, particularly as the service was able to provide outreach in hard to engage with populations;

·                The role of Primary Care in the prevention of diabetes, including adoption of the Manchester Standards with its eight processes of care to standardise care for patients;

·                Data on how the Manchester Standards had reduced the number of emergency hospital admissions;

·                Information on the Community Diabetes Service, the Community Diabetes Education and Support Team, Secondary Care Services, Inpatient Support Services and transition to Adult Services;

·                The work undertaken to deliver Health Care Professional Education;

·                Activities to educate people living with diabetes; and

·                The work to reduce the number of lower limb amputations.

 

Members sought clarification on the information that had been provided in the graphs and tables throughout the report and an explanation was provided as to the various data sets and recording periods.

 

In response to concerns expressed by Members regarding the numbers of reported medical errors Prof Ball described what constituted a medical error, and provided examples of what would be categorised as severe to minor errors. He stated that all errors had a negative impact on patients and their experience of care. He said that all incidents are recorded and reported and practitioners are held to account.

 

Prof Ball explained that the report presented to the Committee reported processes rather than clinical outcomes. He said that this was the beginning of a new approach to the management of diabetes and clinical benefits were understood, however the clinical outcomes would be reported in future years.

 

Dr Rutter responded to questions from Members regarding flash glucose monitoring to improve self-care for patients.He said that this would be provided for those patients with the highest clinical need and funding had been awarded for this.

 

Members commented that the impact of austerity, wage freezes and welfare reform had a significant detrimental impact on people’s health and their ability to make healthy lifestyle  ...  view the full minutes text for item 2.

3.

Primary Medical Care in Manchester pdf icon PDF 688 KB

Report of Dr Manisha Kumar, Clinical Director, Manchester Health and Care Commissioning

 

This report provides information on how quality in Primary Medical Care in Manchester is assessed and improved and also provides an update on Primary Care access.

Additional documents:

Minutes:

The Committee considered a report of the Clinical Director, Manchester Health and Care Commissioning (MHCC) which provided information on how quality in Primary Medical Care in Manchester was assessed and improved.

 

The Clinical Director MHCC referred to the main points of the report which were: -

 

·                Describing the Quality Assurance and Improvement Framework for General Practice;

·                The Early Warning System (EWS) that brought together a range of available data sources to identify a practice being in need of support;

·                Current Care Quality Commission (CQC) ratings for GP Practices across Manchester;

·                Information on the 9 Primary Care Standards based on the Greater Manchester Primary Care Standards, designed to deliver long term improved health outcomes across the City, building on the prevention work and based on Our Manchester; and

·                Information on GP access, including the enhanced 7 Day Access service and Digital Access.

 

Members discussed the issue of non-attenders at GP appointments, both in the core hours offer and the out of hours’ service, noting that the number of non-attendees for the out of hours’ service was currently 20%. Dr Mehra said that the issue of non-attenders for out of hours appointments was being addressed. He advised that previously patients did not have the facility to cancel an appointment out of hours, say on a weekend if their own practice was closed. He said that to address this a dedicated telephone number, operating 24/7 had been established so patients could cancel an appointment if their own practice was closed. He further informed Members that a text message reminder service had also been implemented that provided an option to cancel the appointment if required. He also advised that the ability of the 111 service to book out of hours’ appointments for callers was also being discussed.

 

Members questioned if the availability of out of hours’ appointments was widely known by patients and asked how this offer had been promoted. Dr Mehra advised that training for reception staff had been delivered, advertising campaigns had been delivered and local radio campaigns. He also advised that literature should be available in surgeries, in different languages to inform people of this offer. Mr Ullman advised that they had worked closely with Healthwatch and the Patient and Public Advisory Group to address the promotion of the out of hours’ service and that they also use mystery shoppers to monitor the information given to patients.

 

Members commented that the rationale for the introduction of the extended GP service was to reduce the number of non-emergency attendees presenting at A&E departments. Members asked if analysis of this had been undertaken and requested that this information was included in any future update report. Dr Kumar responded that the service had reduced the number of non-emergency attendees at A&E and assisted with the management of the increased demand on services during the period of winter pressures. The Chair recommended that a report on Winter Pressures and how this was managed is provided for the March meeting.

 

In regard to access  ...  view the full minutes text for item 3.

4.

Delivering the Our Manchester Strategy pdf icon PDF 168 KB

Report of the Executive Member for Executive Member for Adults, Health and Wellbeing

 

This report provides an overview of work undertaken and progress towards the delivery of the Council’s priorities as set out in the Our Manchester Strategy for those areas within the portfolio of the Executive Member for Adult Services.

Additional documents:

Minutes:

The Committee considered the report of the Executive Member for Adults, Health and Well Being, which provided an overview of work undertaken and progress towards the delivery of the Council’s priorities, as set out in the Our Manchester strategy, for those areas within her portfolio.

 

Members welcomed the information provided regarding the funding that had been secured for Smoking Services. The Executive Member for Adults, Health and Well Being said that she acknowledged the work of the recent Task and Finish Group and commented that as smoking contributed to many poor health outcomes for Manchester residents it was important to establish a service that would support people to quit tobacco.  She informed Members that a more detailed report would be submitted to the Committee for consideration at an appropriate time on this area of activity.

 

The Executive Member for Adults, Health and Well Being commented that the ambition of the Local Care Organisation was to deliver services, including prevention services, such as smoking cessation programmes in neighbourhood teams. She said the intention was also to bring together other public services, such as the police into the local teams. She advised that a lot of work had been undertaken around the issue of workforce and that a more detailed report would be submitted to the Committee for consideration at an appropriate time.

 

Members noted the work undertaken to improve Mental Health Services across the city. The Executive Member for Adults, Health and Well Being commented that the journey had been one of improvement and thanked the Committee for their continued challenge in this important area of work. She further informed the Members that work was ongoing at a Greater Manchester level to look at the funding inequalities between children’s mental health services and adult services.

 

The Executive Member for Adults, Health and Well Being stated that she was passionate about challenging the myths that are perpetuated in certain sections of the media regarding asylum seekers in the city. She said she was working to improve services available to support asylum seekers and improve how information was shared with the Local Authority regarding where asylum seekers are housed so that appropriate support could be offered. A Member commented upon the often poor condition of the properties that were offered to asylum seekers by providers, noting that currently there appeared to be no political will from central government to improve this situation.

 

Decision

 

To note the report.

 

5.

Overview Report pdf icon PDF 296 KB

Report of the Governance and Scrutiny Support Unit

 

The monthly report includes the recommendations monitor, relevant key decisions, the Committee’s work programme and items for information. The report also contains additional information including details of those organisations that have been inspected by the Care Quality Commission

(CQC) within Manchester since the Health Scrutiny Committee last met.

 

Additional documents:

Minutes:

A report of the Governance and Scrutiny Support Unit which contained key decisions within the Committee’s remit and responses to previous recommendations was submitted for comment. Members were also invited to agree the Committee’s future work programme. 

 

Decision

 

To note the report and approve the work programme.