Present at the meeting:
- Councillor N D Ash (Chairman)
- Councillor Mrs J M Peet (Vice Chairman)
- Councillor S Dawber
- Councillor Ms L E Fagan
- Councillor Mrs D Fairhurst
- Councillor Mrs J Hurst
- Councillor K W McManus
- Councillor R T Splaine
- Councillor K Cunliffe – Portfolio Holder for Healthier Communities and Older People
Officers in attendance
- Gary Finch – Principal Officer – Scrutiny
- Margaret McKenzie – Solicitor
- Kay Cullen – Trainee Committee Clerk
Officers presenting reports
- Stuart Cowley – Service Director – Strategy and Commissioning
- Louise Sutton – Service Director – Personalisation and Community Services
External Organisations presenting reports
- Linda Agnew – Deputy Managing Director – Ashton, Leigh and Wigan Community Healthcare
- Gail Gaskell - Care Group Manager for Unscheduled Care
- Peter Lakeland – Out of Hours Service Manager
- Peter Rowe – Chief Executive – Ashton, Leigh and Wigan Primary Care Trust
65 Apologies for absence: Councillors N A Bradbury, M A Dewhurst, Mrs S Dewhurst, Mrs S J Greensmith, E N Houlton, E Russon and J Talbot.
66 Minutes: The minutes of the meeting of the Adult Health and Well-being Scrutiny Committee held on 2 March 2010 were approved as a correct record.
67 Whipping Declarations: Government guidance expected Members of Scrutiny Committees not to act in accordance with party whipping and that, if they did, they were to declare it.There were no declarations made.
68 Out of hour’s access to GPs (General Practitioners): The Deputy Managing Director for Ashton, Leigh and Wigan Community Healthcare, Linda Agnew, gave a presentation, which outlined to Members the out of hours GP deputising Service in Wigan. She advised Members of the hours of operation the service was available and the staffing arrangements during these hours. The Deputy Managing Director reported to Members the average number of week night and weekend calls they had received and the number of GPs that would work during those hours.
On average there would be 15 calls per night (midnight to 8.00am), and of those, on average:
- one or two people would be referred to accident and emergency (A&E);
- one would require a home visit;
- three would visit the Primary Care Centre; and
- the remaining ten would be triaged over the phone.
The Deputy Managing Director informed Members, that over the last 12 months the summary of patient satisfaction with the service provided was: 59% excellent, 31% good, 7% satisfactory and 4% poor.
Members were informed that there was a pool of 45 GPs for the borough and all of these were local GPs.
Members asked a number of questions, which included the following points:
- What was the breakdown of the age groups who access the service?
- What could be done to help prevent people presenting themselves to A&E without consulting a doctor first?
- How many out of hours centres were there in the borough?
- How many GPs now offer the extended hours service?
- The Primary Care Trust currently uses local GPs only, what guarantee was there that this would continue?
The Out of Hours Service Manager, Peter Lakeland, informed Members that the majority of people who used the out of hour service were 16 years old and younger.
The Chief Executive of Ashton, Leigh and Wigan Primary Care Trust, Peter Rowe, advised Members that the PCT had walk in centres and GPs working at the doors of A&E to help reduce the number of people accessing A&E who need not do. He also informed Members that it was important to educate people of all the services available and improve their confidence to promote self-care.
The Deputy Managing Director informed Members that there was one out of hours centre in Wigan and this was Incefield House, which was situated on Ince Green Lane, Ince.
The Chief Executive reported to Members that 60% - 70% of GPs were offering the extended hours service, this was higher than the national average, but the PCT would like to work towards 100%. The PCT could not force GPs to offer this service as the GPs were independent contractors.
Members were advised that the PCT had never had the need to use GPs out of the area and with there being a large number of local GPs in the pool there was no foreseeable need to use GPs from out of the Borough.
Resolved: The Committee thanks the Officers for their presentation.
69 Primary Care Trust (PCT) Budget Information: The Chief Executive of Ashton, Leigh and Wigan PCT, informed Members that the NHS was facing one of its biggest challenges to the sustainability of health care services since its creation. He reported to Members the challenges the PCT faced in meeting the Quality, Innovation, Productivity and Prevention agenda and that one of the greatest challenges ahead was the size of the financial savings that were needed to be made. Wigan’s savings were estimated to be in the region of £105 million for the local healthcare economy, which far exceeded any previous challenges the NHS has had to tackle. Wigan Council would also have its own financial challenges, which would further increase the financial burden.
Members were also informed that considerable work had been undertaken through the ‘Transforming Commissioning Saving Lives Review’ but that the estimated productivity improvements of 5% in community services did not go far enough to address the financial gap.
The Chief Executive advised Members that this was the start of a long, challenging process and undertook to keep the Committee updated on the progress of the work undertaken to help tackle the financial savings.
Members asked a number of questions, which included the following points:
- What had been done to help reach the 2013/2014 target?
- What is the PCT doing to help raise the awareness of Stroke?
- The stroke ward for Occupational Therapy was only currently opened Monday to Friday, were there any plans for the ward to be open on Saturday and Sunday?
The Chief Executive informed Members that to help reach the 2013/2014 target, the PCT was currently looking at improving the stroke services and had put other initiatives in place. One of these was the ‘Find and Treat’ programme which helped to raise awareness of the contributory factors of stroke, the age criteria for the programme was being lowered from 50 years to 40 years from the 1 April 2010. The PCT was also setting up a programme for the screening of irregular heartbeats in due course.
Members were advised that the PCT would be commissioning the Stroke ward to be open seven days a week instead of Monday to Friday, in order to improve the services for stroke sufferes.
Resolved: The Committee thanks the Chief Executive of Ashton, Leigh and Wigan PCT for presenting the report.
(Councillor K W McManus declared a personal and non prejudicial interest in this item because his wife is employed by Salford Primary Care Trust)
70 Fair access to care – eligibility criteria: The Committee considered a report that informed Members, that in March 2005, the Council set its eligibility criteria under Fair Access to Services at a level where needs associated with critical and substantial were met. The Service Director, Personalisation and Community Services, Louise Sutton, informed Members that the Council was required to review their eligibility criteria annually in line with their usual budgetary cycle.
Members were informed that the Personal Care at Home Bill was going through the Parliamentary process to be established as legislation with a planned implementation date currently of 1 October 2010. Further reports would be brought to this Committee in due course.
Members asked a number of questions and commented on the various aspects of the report.
Resolved: The Committee:
- thanks the Service Director, Personalisation and Community Services for presenting the report; and
- supports that the eligibility criteria remain at critical and substantial need for 2010-11.
(Councillor S Dawber declared a personal and non prejudicial interest in this item because he is a Trustee Treasurer for the Wigan and Leigh Carers Centre)
71 Adult Services Budget Monitoring Report 2009/10 (month10): The Committee considered a report, which informed Members of the budget monitoring position for Adult Services after the first ten months of 2009-10. Reference was made to the budgetary issues that were being addressed during the year.
Members were advised of the significant underlying budgetary pressure of £1.2 million for 2009-10, that related to transition cases from previous and current years. They were informed that the monitoring position after ten months showed a £1,893,000 overspend and that the Adult Services Improvement Plan 2 had been put into place to deliver a reduction in savings of £244,000 in a year.
The report showed cost pressures associated with care costs which were partially offset by the decreasing impact from continuing care. The current projected out-turn for the Department was an over-spend of £3.05million which included £0.5million from Pay and Reward changes. Excluding Pay and Reward, the projected overspend has reduced from £2.82million to £2.55million. The Senior Management Team was considering further measures that sought to mitigate the level of the overspend.
Members asked a number of questions and made reference to the budgeting of the transition costs of ‘looked after’ children.
Resolved: The Committee:
- thanks the Service Director, Strategy and Commissioning for presenting the report; and
- welcomes the appendices that had been added to the reports.
72 Performance Monitoring Report – Quarter 3: Performance Monitoring Report – Quarter 2: The Service Director, Strategy and Commissioning, Stuart Cowley, presented a report, which provided Members with the Adult Services performance monitoring position for the third quarter of 2009/10.
The report outlined the overall performance for the third quarter of 2009/10, which showed that for the indicators where targets had been finalised and the quarterly data was available, 64% of the indicators were on target or better than the target.
The Service Director, Strategy and Commissioning, informed Members that remedial action was being taken on those areas where performance was shown to be below target and the areas where concerns had been highlighted. The Senior Management Team would also continue to monitor the position closely.
Members asked a number of questions and commented on the various aspects of the report.
Resolved: The Committee thanks the Service Director, Strategy and Commissioning for presenting the report.
73 Single Commissioning Agency Joint Shadow Board minutes: The minutes of the meeting of the Single Commissioning Agency – Joint Shadow Board from 21 January 2010 were submitted for information.
Resolved: The Committee notes the minutes now submitted.
