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LancashireCountyCouncilAdultSocialCareandHealthOverviewandScrutinyCommitteeTuesday8July2008at10.
30aminCabinetRoom'C',CountyHall,PrestonAgendaPart1(OpentoPressandPublic)No.
Item1.
AppointmentofChairandDeputyChairsTonotetheappointment,bytheFullCouncilon29May2008,ofCountyCouncillorTimOrmrodasChairoftheCommitteeandCountyCouncillorsTerryAldridge,MikeCalvertandStephenSutcliffeasDeputyChairsfortheensuingyear.
2.
Constitution,MembershipandTermsofReference(Reportattached)3.
DisclosureofPersonalandPrejudicialInterestsMembersareaskedtoconsideranyPersonal/PrejudicialIntereststheymayhavetodisclosetothemeetinginrelationtomattersunderconsiderationontheAgenda.
4.
MinutesoftheMeetingheldon27May2008(Copyenclosed)5.
CommunityEquipmentAssessments(Reportattached)6.
LancashireTeachingHospitalsFoundationNHSTrust–MaternityServiceReview(Reportattached)7.
LINksinLancashire(Reportattached)8.
ReportoftheEquitableAccessinPrimaryMedicalCareProcurementTaskGroups(Reportattached)9.
TTobaccoControlConsultation(Reportattached)10.
ConsiderationoftheForwardPlan(Reportattached)11.
WorkPlanning2008/09(Reportattached)--2No.
Item12.
ItemsforInformation(Reportattached)13.
UrgentBusinessAnitemofurgentbusinessmayonlybeconsideredunderthisheadingwhere,byreasonofspecialcircumstancestoberecordedintheMinutes,theChairmanofthemeetingisoftheopinionthattheitemshouldbeconsideredatthemeetingasamatterofurgency.
Whereverpossible,theChiefExecutiveshouldbegivenadvancewarningofanyMember'sintentiontoraiseamatterunderthisheading.
14.
DateofNextMeetingThenextmeetingoftheCommitteewillbeheldonTuesday23September2008at10.
30amattheCountyHall,Preston.
IMFisherCountySecretaryandSolicitorCountyHallPrestonAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
2ElectoralDivisionaffected:NoneConstitution,MembershipandTermsofReferenceoftheCommittee(Appendix'A'refers)Contactforfurtherinformation:MelOrmesher,01772536659,OfficeoftheChiefExecutiveExecutiveSummaryThisreportsetsouttheconstitution,membershipandtermsofreferenceoftheCommittee.
RecommendationTheCommitteeisaskedtonotethereport.
Backgroundi)ConstitutionandMembershipTheFullCouncil,atitsmeetingon29May2008,agreedthattheAdultSocialCareandHealthOverviewandScrutinyCommitteeshallcomprise15CountyCouncillors(onthebasisof8:5:1:1)and12non-votingco-optedmembers,witheachDistrictCouncilbeinginvitedtonominatearepresentative.
ItwasalsoagreedthatCountyCouncillornominationstoserveontheCommitteeshouldbesubmittedtotheCountySecretaryandSolicitorbytherespectivePoliticalGroups.
Accordingly,themembershipoftheCommittee,asconfirmedbythePoliticalGroupSecretariesandthe12LancashireDistrictCouncils,isasfollows:CountyCouncillorsTAldridgeMParkinsonMCalvertLScottCBCoatesJSSutcliffeJEatonCWaltonSJLargeMrsDWestellMrsMMartinMrsMWilsonLTOrmrodPWilsonMrsVMWilson-2-Non-votingCo-optedmembersLancasterCityCouncil-CouncillorKFarrowWyreBoroughCouncil-CouncillorJRobinsonRibbleValleyBoroughCouncil-CouncillorMrsBHiltonFyldeBoroughCouncil-CouncillorRFulfordBrownPrestonCityCouncil-CouncillorMrsMMcManusSouthRibbleBoroughCouncil-CouncillorCCoultonChorleyBoroughCouncil-CouncillorRRussellWestLancashireDistrictCouncil-CouncillorMrsDStephensonHyndburnBoroughCouncil-CouncillorPBartonBurnleyBoroughCouncil-CouncillorATatchellPendleBoroughCouncil-CouncillorPMcCormickRossendaleBoroughCouncil-CouncillorMrsGSandifordTheCommitteehasasteeringgroupmadeupoftheChair&DeputyChairs,theprincipalroleofwhichistomanagetheagendaoftheCommittee,withparticularreferencetoitsstatutoryresponsibilitiesinrelationtotheNationalHealthService.
ii)TermsofReferenceTheTermsofReferenceoftheCommitteearesetoutatAppendix"A"forinformation.
ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtFullCouncilagenda29May2008ChrisMather,OfficeoftheChiefExecutiveExt.
33559ReasonforinclusioninPartII,ifappropriateN/A1Appendix'A'AdultSocialCareandHealthOverviewandScrutinyCommitteeTermsofReferenceNote:TheCommitteeshall,forthepurposeofexercisingitsstatutoryfunctionsofahealthoverviewandscrutinycommittee,comprisetwelvenon-votingdistrictcouncilmembers1.
Toreviewdecisionsmade,orotheractiontaken,inconnectionwiththedischargeofanyrelevantfunctionsundertakenbytheCabinetcollectivelyortherelevantCabinetMember.
2.
TomakereportsorrecommendationstotheFullCouncil,theCabinetortherelevantCabinetMemberwithrespecttothedischargeofanyrelevantfunctionsundertakenbytheCabinetcollectivelyortherelevantCabinetMember.
3.
Inreviewingdecisions(otherthandecisionsdesignatedasurgentunderStandingOrder65)madeinconnectionwiththedischargeofanyrelevantfunctionsundertakenbytheCabinetcollectivelyortherelevantCabinetMember,butwhichhavenotbeenimplemented,theCommitteemayrecommendthatthedecisionbereconsideredbythepersonwhomadeitortoreferthedecisiontotheFullCouncilforittodecidewhetheritwishesittobereconsideredbythedecisiontaker.
4.
ToconsideratitsdiscretionasappropriateForwardPlanspreparedbytheLeaderwithaviewtodeterminingwhich,ifany,oftheproposeddecisionsitwishestoscrutinise.
5.
Toholdgeneralpolicyreviewsandtoassistinthedevelopmentoffuturepoliciesandstrategies(whetherrequestedbytheFullCouncil,theCabinet,therelevantCabinetMemberordecidedbytheCommitteeitself)and,afterconsultingwithanyappropriateinterestedparties,tomakerecommendationstoeithertheCabinet,therelevantCabinetMemberortotheFullCouncilasappropriate.
6.
ToreviewandscrutiniseanyCountyCouncilservicesplannedorprovidedaspartoftheCouncil'swiderresponsibilitytoseekhealthimprovementsandreducehealthinequalitiesforLancashireanditsinhabitants,andtomakerecommendationstotheFullCouncilortheCabinet,asappropriate.
7.
ToreviewandscrutiniselocalservicesplannedorprovidedbyotheragencieswhichcontributetowardsthehealthimprovementandthereductionofhealthinequalitiesinLancashireandtomakerecommendationstothoseagencies,asappropriate.
8.
ToreviewandscrutinisetheoperationofNHSservicesinLancashireinaccordancewiththeHealthandSocialCareAct2001andmakereportsandrecommendationstoNHSbodiesasappropriateandinthecaseofcontestedNHSproposalsformajorservicechangestoreferthemattertotherelevantSecretaryofState.
29.
TorefertotherelevantSecretaryofStateanyNHSproposalwhichtheCommitteefeelshasbeenthesubjectofinadequateconsultation.
10.
ToscrutinisethesocialcareservicesprovidedorcommissionedbyNHSbodiesexercisinglocalauthorityfunctionsunderSection31oftheHealthAct1999.
11.
Toestablishasnecessaryjointworkingarrangementswithdistrictcouncilsandotherneighbouringauthorities.
12.
Todrawupaforwardprogrammeofhealthscrutinyinconsultationwithotherlocalauthorities,NHSpartnersandotherkeystakeholders.
13.
Tooversee,monitorandscrutiniseBestValuereviews,tomakerecommendationstotheCabinetonthecontentofServiceImprovementPlansandtomonitorprogressontheimplementationofthePlans.
14.
ToconsideranymatterreferredtotheCommitteebytheManagementCommitteefollowingarequestbyaMemberoftheCouncil,aDistrictCouncilMemberoftheCommitteeoraco-optedMemberoftheCommitteewhowishestheissuetobeconsidered.
15.
Toestablishsub-committees,taskgroupsandotherworkinggroupsandpanelsasnecessary.
16.
TorequesttheChiefExecutivesoflocalNHSbodiestoattendbeforetheCommitteetoanswerquestions,andtoinvitethechairsandnon-executivedirectorsoflocalNHSbodiestoappearbeforetheCommitteetogiveevidence.
17.
ToinviteanyofficerofanyNHSbodytoattendbeforetheCommitteetoanswerquestionsorgiveevidence.
18.
ToinvitetoanymeetingoftheCommitteeandpermittoparticipateindiscussionanddebate,butnottovote,anypersonnotaCountyCouncillorwhomtheCommitteeconsiderswouldassistitincarryingoutitsfunctions.
19.
TorecommendtheFullCounciltoco-optontotheCommitteepersonswithappropriateexpertiseinrelevanthealthmatters,withoutvotingrights.
20.
TorequireanyCouncillorwhoisamemberoftheCabinet,theappropriateExecutiveDirectororaseniorofficernominatedbyhim/her,ortheManagingDirectorofaDirectServiceOrganisationtoattendanymeetingoftheCommitteetoanswerquestionsanddiscussissues.
21.
ToorganiseappropriatetrainingformembersoftheCommitteeonhealthrelatedissues.
1LancashireCountyCouncilAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingheldon27May2008attheCountyHall,PrestonMinutesPresent:CountyCouncillorTOrmrod(Chair)CountyCouncillorsTAldridgeMParkinsonMCalvertKRileyCCoatesRShepherd1SLargeCWaltonMMartinMrsMWilsonMrsVWilsonApologiesforabsencewerepresentedonbehalfofCountyCouncillorsEScottandSSutcliffe.
1CountyCouncillorRShepherdreplacedCountyCouncillorJEatonforthismeeting.
Co-optedDistrictCouncillorsCCoulton-SouthRibbleBoroughCouncilKFarrow-LancasterCityCouncilMrsBHilton-RibbleValleyBoroughCouncilMrsMMcManus-PrestonCityCouncilRRussell-ChorleyBoroughCouncilMrsGSandiford-RossendaleBoroughCouncilMrsDStephenson-WestLancashireDistrictCouncilApologiesforabsencewerepresentedonbehalfCouncillorRFulfordBrown(Non-voting,FyldeBoroughCouncil).
TheChairwelcomedanewrepresentativefromLancasterCityCounciltothemeeting,CouncillorKFarrow.
DisclosureofPersonalandPrejudicialInterestsTherewerenodisclosuresofpersonalorprejudicialinterests.
ConfirmationofMinutes68.
Resolved:-ThattheMinutesofthemeetingheldon15April2008,asnowpresented,beconfirmedandsignedbytheChair.
2CentralLancashirePrimaryCareTrust–PrioritiesandPlans2008/09TheChairwelcomedDoreenHounslea,DirectorofCommissioningandCommunityEngagement,andBeverleyJohnson,AssociateDirectorofServicePlanningforCentralLancashirePrimaryCareTrust(PCT).
DoreenHounsleapresentedthePCT's5yearstrategyandgaveanoverviewofthePCT,togetherwithdetailsofthePCT'splansandprioritiesforactionin2008/09.
TheCommitteewasinformedthatthePCTservedthe450,000peopleregisteredwithaGPintheareasofChorley,Preston,SouthRibbleandWestLancashire.
AscustodiansoftheresourcesallocatedfortheNationalHealthServiceinCentralLancashire,thePCTwereaccountablefortheefficientandeffectiveuseof682mofpublicmoneyeachyear.
ItwasreportedthatCentralLancashirehadreceivedanadditional33mgrowthmoneyin2008/09withafurther15mbeingreleasedfrombudgetstosupporttheimplementationofthePCT'splanandpriorities.
Thiswasafterareviewofexistingcommissioningplansandcommitments.
ThestrategicframeworkagreedbythePCTboardincludedthefollowingthreegoals:ToimprovethelengthandqualityoflifeforthepeopleofCentralLancashire.
Toexpandhealthserviceswheretheyweremostneeded.
Toenablepeopletotakegreaterresponsibilityfortheirownhealthandhealthcare.
Tomakethesegoalsmorerealforthelocalpopulation,thePCThadmadethefollowingcommitmentsforthenextfiveyears:ThePCTwould:increaselifeexpectancybyworkingwiththelocalpopulationandinpartnershipwithothers.
eliminateunnecessaryorunwantedwaitingtoreceivethehealthcareneeded.
establishwithincommunities,servicesthatprovidedfirstclasscareforpeoplewithlongtermconditions.
provideopportunitiesforpeopleandcommunitiestohavegreatercontrolovertheirownhealth.
TheCommitteewasinformedthatthePCTwasrequiredtoworkwithinnationalframeworksandthenationalprioritiesfor2008/09identifiedfordevelopmentfromtheoperatingframeworkwere:Improvedcleanlinessandreducedhealthcareassociatedinfections.
Improvedaccessthroughachievementof18weekreferraltotreatmentpledgeandimprovingaccesstoGPservices.
3ImprovedhealthinadultsandchildrenandreducedhealthinequalitiesImprovementofpatientexperience,staffsatisfactionandengagementEmergencypreparedness.
'VitalSigns'providedalistofindicatorsofhowtheNHSwasperforminglocallyandnationally.
TheindicatorshadbeendevelopedtoencourageandenablepartnershipworkingtodeliverjointoutcomesthroughLAAsandthePCToperationalplans.
TheindicatorsfellintothreecategoriesandthePCT'sprioritiesweremonitoredagainstthefollowingtiers:Tier1National'must-dos'–thingspatients,publicandstaffsaidwereimportant.
Tier2NationalprioritiesbutlocalflexibilityinhowactionwastakenForward.
Tier3Localprioritiesandstretchedtargetsinthoseareasmostrelevanttotheneedsandexpressedviewsofthelocalpopulation.
TheinvestmentprioritiesofthePCTwereconfirmedasfollows:'mInflationupliftstoHealthcareProviders18.
6Accessandcapacity7.
8EquitableAccess1DentalServices2SpecialistandCollaborativeCommissioning4PracticeBasedCommissioning1.
6Cancer0.
5Children'sandMaternity0.
6LongTermConditions2.
3MentalHealth1.
3EngagementandPartnership0.
5FutureCapitalDevelopments1.
3DoreenHounsleaandBeverleyJohnsonrespondedtoMemberscommentsandquestions.
Themainpointsaresummarisedbelow:ThePCTapologisedforthelengthyreport(Appendix'A')anditslatereceipt.
SpecificinvestmenttargetareasasagreedbythePCTBoardweresetoutintheLocalDeliveryPlan.
ThePCTagreedtoprovideasummaryforcirculationtomembersoftheCommittee.
GP'swerethefirstlineofdefenceandthePCTwasworkingwiththelocalmedicalcommitteestoimproveaccesstoGPs.
TheimplicationsoftheDarziReporthadtobelookedat.
However,itwasimportanttoensurethattherightprimarycarewasprovidedinthemostappropriatelocation.
PrimarymentalhealthindeprivedareaswasaconcernandtherewasaneedtoreviewtheservicesinareassuchasSkelmersdale.
Itwasimportanttolookatwhocouldprovidebetterservices,andalsoto4deliverservicesclosertohome.
ItwasconfirmedthatthePCTwaslookingtore-tenderthementalhealthservicesinthemostdeprivedareas.
MembersenquiredhowChildren's/MaternityServiceshadbeenformulated.
ItwasreportedthatthePCThadundertakenanationalbaselineassessmentonMaternityServicesandthatthePCTwasalsoworkingcloselywithLancashireTeachingHospitals.
Thiswouldhelpinformfutureinvestmentintheseareas.
ThefundingofChildren'sServicesoverthenextthreeyearswassetoutinthePCT'sPlan.
However,thiswouldnotbetheendofthefundingandthePCTwaslookingathowtheycouldsupportchildrenincludingfurtherinvestmentafterthethirdyear.
Childobesitywasapriorityarea.
Understrategicprioritiesforcanceritwasnotedthatonlychecksandscreeningforwomenwerementioned.
TheCommitteewasassuredthattherewasnobiastowardswomenandthatthePCTwasdoingalotofworkwithmen'sgroups.
Aconcernwasexpressedabouttheelderlybeinglookedafterbyuntrainedpeople.
AVulnerableAdultsProgrammehadbeenlaunchedrecently.
Therewerefarmorestringentcheckscarriedoutoncarers.
Theseincludedqualificationandbackgroundchecks.
WouldCommunityMatronshelppreventpatientsfallingthroughthenetwasaconcernvoicedbytheCommittee.
ThePCTconfirmedthatcasemanagerswereworkingwithCommunityMatronstomakesurethatdischargedpatientswereproperlylookedafter.
AnewSeniorCommunicationsAdvisorhadbeenappointedbythePCT.
tohelppromotethePCT'smessageabouthealthandwellbeingtothepublicandimprovetheircommunicationsoverall.
ThePCThadrecentlyheldfiveHealthForumswhichhadbeenverywellattended.
MRSAandC.
DifficileratesweremonitoredwithregularreportsbeingpresentedtothePCTboard.
ThePCTofferedtomakethereportsavailabletotheCommittee.
ThePCTadvisedthatGPsshouldstillofferannualhealthcheckstotheelderly.
IfthisdidnothappenthenthePCTwashappytolookintothematter.
ThedelayedintroductionofLINKSmeantthatthePCThadmaintaineditslinkswiththeformermembersofthePatientandPublicInvolvementForums.
TheChairthankedthePCTfortheirpresentation.
69.
Resolved:i.
ThatthereportonCentralLancashirePrimaryCareTrust'sPrioritiesandPlansfor2008/09benoted.
ii.
ThattheinformationpresentedanddiscussedatthemeetingbeusedtoinformtheCommittee'sworkplanningprocess.
5NorthLancashirePrimaryCareTrust–PrioritiesandPlans2008/09TheChairwelcomedDrFrankAtherton,DirectorofPublicHealth,andKevinParkinson,DirectorofFinanceandDeputyChiefExecutivewhopresentedNorthLancashirePrimaryCareTrust'sPrioritiesandPlansfor2008/09.
Membersexpresseddisappointmentwiththelengthandcomplexityofthereport.
ThePCTrepresentativesapologisedforthisandforthelatesubmissionofthereport.
TheCommittee'sattentionwasdrawntoannualpublichealthreportwhichhelpedinformthePCT'spriorities.
TheCommitteewasremindedthatthePCTservedapopulationofover320,000inFylde,WyreandLancaster.
ThePCTneededtoaddressthemaincausesofmorbidityandmortalityamongstthepopulationandhadfoundNorthLancashiretobenotmuchdifferentthanelsewhereinthecountry.
Themaincausesofdeathintheareawerecancer,CoronaryObstructivePulmonaryDiseaseandcardiovasculardiseases.
Tacklingthesewasoneofthemain'disease'prioritiesforthePCT.
ThePCTbelievedthattherewasagoodnewsstoryinNorthLancashireinthathealthandtheoverallhealthexperiencehadimprovedinthelast10-15yearsandthatthetrendinmortalitywasreducing.
ThePCTconfirmeditsotherlifestyleprioritiesthatweredrawnfromthe'ChoosingHealth'WhitePaperasbeing:TobaccoControlObesity,PhysicalActivityandFood/NutritionInfantFeedingAlcoholSexualHealthMentalHealthOralHealthThePCThadundertakenasignificantamountofpublicengagementworktoseewhatcommunitieswantedandwhattheysawastheirpriorities.
Keymessagesreceivedwere:KeepwaitingtimestoaminimumImproveaccesstoNHSdentistsInvestmoreresourcesinpreventingratherthantreatingill-healthWorktoreducehealthinequalitiesReduceinfectionssuchasMRSAandC.
DifficileMoreconvenientaccesstoservicesBettercommunicationThePCThadstructureditselfinNorthLancashirearoundanumberofcommissioningthemesorstrandsandworkwouldbedevelopedaroundthesestrands.
Alloftheprioritiescomingfromthediseaseburden,thepublichealthprioritiesandfromcommunityperceptionswouldfeedintooneofthestrandsin6someform.
ThePCT'sinvestmentprogrammewasalsostructuredaroundthestrands.
Actionswhichthepublicsectorsuchaslocalauthoritiescouldtaketoimprovehealthincluded:Bettersupporttotheworkforcee.
g.
assistanceforthosewishingtostopsmoking.
Theplanningsystemtoconsidertheimpactofnewinfrastructureonhealth.
Morestringentuseofregulatorypowers.
ThePCThadachievedthefollowingtargetsbytheendof31March2008butthelistwasnotexhaustive:18weeksmilestonesatUniversityHospitalMorecambeBayandBlackpoolVictoriaHospitalCancer–2weekwait,31and62daysachievedImprovedaccesstoGPandPrimaryCareProfessionalsCategoryAambulanceresponseswithin19minutesPatientswaitinglessthan4hoursinA&EThefollowingtargetswerenotachievedby31March2008:Mostoftheambulanceresponsetimes.
However,thePCTfeltthatthiswasadifficultareatomeasureastheAmbulanceTrustcoveredtheNorthWestandperformancewasmeasuredacrosstheregionandnotbyindividualarea.
ThePCTwasworkingwiththeambulanceserviceandbelievedthatstepscouldbetakentoimprovemattersandthiswasakeyareaforthenewyear.
ChooseandBook(electronicbookingsystem)failedtomeettargetsbuttheNationalPatientSurveyreported63%wereofferedchoicethroughGPreferralandthiswasalsosomethingwhichthePCTwasmeasuredon.
ImprovementsinMentalHealthduetostaffnotbeinginplaceintimetomeetthetargets.
Considerableworktodevelopthecommissioningstrategiesaroundthekeythemesorstrandswasbeingundertaken.
Manyofthethemesorstrandsinterfacedwitheachotherandthestrategieshadtotakethisintoaccount.
WhenthePlanwasapprovedbythePCTBoardmanyofthecommissioningstrategieshadnotbeenapprovedandtheBoardhadthereforeallocatedsumsofmoneyaroundthekeythemesorstrands.
Furtherdetailswerepresented.
ThePCTproposedtoinvestanadditional18monnewservicesin2008/09.
Thiswasinadditiontothe0.
5bspentinNorthLancashire.
Withthisnewinvestmentthekeyprioritiesfor2008/09were:Achievetargetsnotmetin2007/08Developcommissioningstrategiesforeacharea,takingintoaccounttheDarzireview7DeliverEquitableAccesstoPrimaryMedicalCareprogrammeMaintain18weekstargetReducehealthinequalitiesImproveaccesstodentalservicesImproveaccesstoorthodonticsserviceInvestinillhealthpreventionFurtherdevelopPrisonHealthserviceMovetomore"communitybased"servicesInvestincontinuingcareservicesImproveunscheduledcarepathwaysAchieveLAA/VitalSignstargetsFrankAthertonandKevinParkinsonrespondedtoMemberscommentsandquestions.
Themainpointsaresummarisedbelow:TheHealthFastForwardSchemehadseenthePCTvisitinganumberofvenuesinitsareainordertoseekviewsoflocalcommunities.
PCTstaffwentalongwithanambulancetoeachvenueandmetwitharound100people.
Therewerealsoboothsatthevenueswherepeoplecouldairtheirviewsinprivate.
Anaffiliationschemehadalsobeensetupwheremembersofthepubliccouldregistertheirinterestinhealthandabout3000peoplewerenowconsultedbythePCTviathisscheme.
TherewasadesireinNorthLancashiretoimproveaccesstoprimarycareservicessothatpeoplecouldgetaccesswhentheywantedit.
TherewasnotastaffingshortagebutthePCTneededtoensurethatstaffweredoingtherightjobsandprovidingthemostappropriateservices.
ThePCTalsoneededtoensurethatitwasgettingthemostefficientandeffectiveservicefromitsworkforce.
Therehadbeenadditionalinvestmentinpreventiveserviceswithparticularsignificantinvestmentincardiovasculardiseaseprevention,additionalscreeningprogrammes,andperiodichealthchecks.
LastyeartheSchoolNursingServicehadalsoreceivedsignificantinvestment.
ObesityinchildrenwasamajorpriorityandwasamainchapterinthePublicHealthReport.
ThePCTwasinvestingheavilyintheHealthySchoolsProgramme,indietetics,andthroughPrimaryCareinthetrainingofnursesinthecareofobesechildren.
Concernwasvoicedaboutmixedsexwards.
ThePCTconfirmedthatNorthLancashiredidnothaveanymixedsexwards.
AmemberrequestedthatareportonmixedsexwardsbepresentedtoafuturemeetingoftheCommittee.
TheChairadvisedthattherequestwasabitprematureandthatitshouldbegivenfurtherconsiderationaftertheEastLancashirePCThadpresenteditsplansandprioritiesfor2008/09totheCommittee.
ThePCTrecognisedthattherewerelotsofpeoplewhowerehardtoreachandtheHealthFastForwardSchemehadtriedtotargetspecificarease.
g.
mosques,thePolishcommunity.
Theyweretryingtogettheaffiliateprocessintothesespecificareastoopenupthechainofcommunication.
Throughtheirworkforcetheyweretryingtogetnewservicesandnewfacilitiesouttotheseareas.
ThePublicHealthAgendawastryingtotargetthesepeopleaswell.
WhilstthePCTstillhadalong8waytogo,ithaddonealotintryingtomakecontactwiththehardtoreachgroups.
Intermsofhospitalavoidance,thePCTwasworkingwiththeevidenceandclinicalresearchadmissionstohospitalsandattendancetoA&E.
TherewassignificantevidencefromthisresearchthatalotofpeopledidnotrequiretheservicesofahospitalbedorA&E.
ThePCTfeltthatupwardsof30%ofpeopledidnotneedtoattendA&EandPrimaryCareEnhancementUnitswerebeingdevelopedtotryandreducethisfigure.
ThePCTwasmakingasignificantinvestmentinpreventionandparticularlyinareassuchasobesity,alcohol,cardiovasculardisease,screeningprogrammesandperiodichealthchecksforpeopleaged45andover.
TheChairthankedthePCTfortheirpresentation.
70.
Resolved:i.
ThatthereportonNorthLancashirePrimaryCareTrust'sPrioritiesandPlansfor2008/09benoted.
ii.
ThattheinformationpresentedanddiscussedatthemeetingbeusedtoinformtheCommittee'sworkplanningprocess.
LocalInvolvementNetworks(LINks)TheChairwelcomedJanetBeadle,ProgrammeDirectorforWellbeing,AdultandCommunityServices,andJonGarnett,StrategicDevelopmentOfficer,whoprovidedanupdateonthedevelopmentofLocalInvolvementNetworks(LINks).
LINkswerebeingdevelopedtocreatealocalsystemwhereeverycitizen,fromeverysectionofthecommunity,hadtheopportunitytosaywhattheywantedfortheirlocalcareservices,withtheknowledgethatthepeoplewhoplannedandranthemwouldlistenandrespond.
LINkswouldreplacePatientandPublicInvolvementForums,andwoulddeveloptheroletocoverbothHealthandSocialCare.
Thiswassupposedtobeinplaceby1April2008.
FinancialallocationswerepublishedinDecember2007,andLancashirewasallocatedagrantof455,000for2008,456,000for2009,and457,000for2010specificallytosupportthedeliveryofLocalInvolvementNetworksinLancashire.
ThesemonieswouldbepaidviatheAreaBasedGrantonamonthlybasis.
ACommitteeitemtowaivestandingordersinMarch2008establishedtheappropriateprocessforuseofthesemoniesforLINks.
TheGovernmentstargetofLINksgoingliveby1April2008wascompromisedbythetimescalesassociatedwithEuropeanProcurementrequirementstakinguptosixmonths,sotheGovernmentestablishedanationaltransitionperiodfrom1April2008until30September2008,toenableallLocalAuthoritiestogolivewithinthisperiod.
LancashireestablishedanAdvisoryBoardtooverseethedeliveryoftheLINkinthistransitionalperiod.
ItestablishedacontractwiththeBlackHealthAgency(BHA)inManchestertoundertakethedevelopmentofthemembershipdatabaseandthepromotionofdiscussionwithallpotential9stakeholdersintheLINkastowhatformandstructuretheLINkshouldtake.
ThediscussionwithstakeholderswascrucialtoaddressperceptionsofwhatLINkswouldbe.
Theclosingdateforapermanenthostwas27May2008andtenderedbidshadnowbeenreceived.
Interviewswerescheduledfor6June2008,andtheappointmentwastargetedat1August.
Thiswastoallowthepermanenthosttohavestaffinginplaceinordertogoliveon1September.
LancashirewasontrackandhadmettheGovernment'stimescales.
TheGovernmentsetupaNationalCentreforInvolvementattheUniversityofWarwickandpublishedaseriesofgoodpracticeguides.
TheAdvisoryBoardhadbeenworkingverycloselywiththeseguides.
LINkswerebeingsetuptogivecommunitiesastrongervoiceinhowhealthandsocialcareservicesweredelivered.
LINkswerequiteclearlytargetedatthewholepopulationofLancashire.
GovernmentguidancestatedclearlythatLINkswereverydifferentfromanypreviousinvolvementmechanismandnoonehadmorerightthananyothertosettheagenda.
AftertheappointmentofafulltimehosttheLINkwouldberesponsiblefordecidingitsownbusiness.
Theguidancealsostatedthatinthetransitionalperioditwasimportantto:-NetworkexistingnetworksWorkwithVoluntary,CommunityandFaithSectorExplorenewwaysofworkingAcknowledgethecomplexityofthisdevelopmentfromaLancashireperspectiveDevelopadialoguewiththecommunitiesofLancashireLINkswereencouragedtoinvesttimeandresourcesduringthe"gettinggoing"phasetoseektheviewsoflocalcommunitiesabouthowtheywantLINkstoberun.
ThiswasbeingdonewithBHAduringthetransitionphase.
TheBHAhadbeenrequestedtoproduceareportwhichwouldbegiventothepermanenthostoutliningprogressincludingtheviewsoflocalcommunities.
Inthe"gettinggoing"phasetheroleofthehostwouldbeto:MakelocalcommunitiesawareofLINksGetlocalpeopleinvolvedHelptodecidehowtoorganiseandtakedecisionsandbegintocarryoutactivities.
TheissueofLINks'membership'wascomplex:PeopledidnotneedtojoinorbelongtoaLINktotakepartSomepeoplemighthavethetimeandskills,andwishedtobecomemoreinvolvedSomepeoplemightchoosetobecomeinvolvedinspecifichealthorsocialcareissuesSomepeoplemightwishtocontributetheirviewsaboutarangeofissuesorasingleissue10LINksshouldenablepeopletobecomeinvolvedinwaysthatsuitthemAprimaryroleforLINkswastoinfluencethewaythathealthandsocialcareneedswereassessedandhowserviceswereplannedanddeliveredtomeetthoseneeds.
PrimaryCareTrustsandLocalAuthoritieshadadutytoworktogethertoproduceJointStrategicNeedsAssessment.
Thishadtoincludeevidenceoftheshareholderinvolvementandengagementwithcommunities.
ThekeytoaLINks'abilitytoinfluencehealthandsocialcareserviceswouldbeitsabilitytobuildgoodrelationshipsandnetworkswith:CommissionersProvidersofhealthandsocialcareStakeholdersOverviewandScrutinycommitteesInspectorsandregulatorsLocalstrategicpartnershipsTheChairstressedtheimportanceofLINkssofarastheworkoftheCommitteewasconcerned.
TheofficerswerethenthankedfortheirworkingettingLancashiretowhereitwas.
Itwasacknowledgedthatlocalitydeliveryandfocuswasverymuchworkinprogress.
ItwasclearthatbridgesneedtobebuiltbetweenLINksandtheworkaroundtheNeighbourhoodEngagementStrategy,aswellasLSPswhowereincreasinglythedriverstochangeinhealthandwellbeing.
Aframeworkwasneededthatcouldoperatestrategicallyandmorelocallyatthesametime.
71.
Resolved:i.
ThattheprogressreportonthedevelopmentofLINksinLancashirebenoted.
ii.
ThatafurtherreportonthedevelopmentofLINksbepresentedtothenextmeetingoftheCommitteeandtofuturemeetingsasnecessary.
ReportoftheAdultSocialCareandHealthOverviewandScrutinyCommitteeSteeringGroupTheSteeringGroupReportcontainedanoteofthemeetingheldbetweentheAdultSocialCareandHealthOverviewandScrutinySteeringGroupandrepresentativesfromLancashireCareFoundationTrustonthe24April2008.
RepresentativesoftheTrustbroughttotheSteeringGroup'sattentiontheproposaltorelocatelow-secureprovisionformenfromitscurrentsiteinLancastertoPrestonwherewomen'sserviceswerealreadylocated.
Appendix'A'ofthereportstatedtheproposaltorelocatesecureserviceprovisionfromLancastertoPrestonwasconsideredtobeanimprovementbylocatingmen'sandwomen'sservicesonthesamesitetothesameservicestandard.
1172.
Resolved:i.
ThatthereportoftheAdultSocialCareandHealthOverviewandScrutinySteeringGroupfromitsmeetingwithrepresentativesfromtheLancashireCareFoundationTrustonthe24April2008benoted.
ii.
TheproposaloftheLancashireCareFoundationTrusttorelocatelow-secureserviceprovisionformenfromLancastertoPrestonbesupportedandthattheTrustberecommendedtoinvolveserviceusersandcarersinplanningthechange.
ConsiderationoftheForwardPlanTheCommitteeconsideredtheForwardPlanforMay2008toAugust2008,insofarasitrelatedtofourkeydecisionsthatwererelevanttotheCommittee'sareaofwork.
AnelectroniclinkhadbeenprovidedtothefullForwardPlan,whichwasavailableontheCountyCouncil'swebsite:http://www.
lancashire.
gov.
uk/council/meetings/forwardPlanOfKeyDecisions.
aspMemberswereremindedthatwheretheywereinterestedinadecisiontobemadeintheForwardPlantheyshouldlookontheintranetandusethelinkssituatedbesideeachdecisiontogetmoreinformation.
Memberscouldthencontactthedecisionmakerorreportauthorsformoreinformation.
IftherewerestillconcernsaboutadecisiontobemadethenmembersshouldcontactthechairoftheCommitteedirectlytodecideonacourseofaction.
73.
Resolved:ThatthereportnowpresentedonthecurrentForwardPlanofExecutiveKeyDecisionsbenoted.
WorkPlan2007/2008TheplansummarisedtheworktobeundertakenbytheCommitteefor2007/2008asrecommendedbytheCommittee'sSteeringGroup.
AstatementofthecurrentstatusofworkbeingundertakenbytheCommitteewouldbepresentedtoeachmeetingoftheCommitteeforinformation.
ThesummarywasavailableontheCountyCouncil'swebsiteat:http://www.
lancashire.
gov.
uk/council/meetings/displayAgendas.
aspmeetid=5100ArequestwasmadeforMRSAandC.
DifficiletobelookedatmorecomprehensivelyintheWorkPlanwhichwasagreed.
AnenquirywasmadeastowhenthesubjectofteenagepregnancieswouldbeincludedintheWorkPlan.
ItwasreportedthatthiswouldbeconsideredatthenextmeetingoftheAdultSocialCareandHealthSteeringGroup.
ThenextCommitteemeetingwouldthenhavearevisedsummaryoftheWorkPlan.
74.
Resolved:Thatthereportbenoted12ItemsforInformationAlistofitemsforinformation,backgroundreadingandgeneralinterestforMay2008waspresented.
ItwasbroughttotheCommitteesattentionthatthereweresomeimportantitemstolookat.
75.
Resolved:Thatthereportnowpresentedsettingoutitemsofinformationoncurrentissuesintheareaofadultsocialcareandhealthbenoted.
DateofNextMeetingItwasnotedthatthenextmeetingofthecommitteewouldbeheldonTuesday8July2008at10.
30amattheCountyHall,Preston.
IMFisherCountySecretaryandSolicitorCountyHallPrestonAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
5ElectoralDivisionaffected:AllinEastLancashireCommunityEquipmentAssessmentsContactforfurtherinformation:TomDaniels,(01254)220828,AdultandCommunityServicesDirectorateTom.
daniels@ssd.
lancscc.
gov.
ukExecutiveSummaryLancashireCountyCouncilassumedtheresponsibilityforthemanagementoftheassessmentforcommunityequipmentandadaptationsinEastLancashirefromthe1April,2008.
Thisreportprovidesanupdateontheprogressofimplementationofthisdecision.
RecommendationTheAdultSocialCareandHealthOverviewandScrutinyCommitteeareaskedto:(i)notetheprogressofthisproject;and(ii)makerecommendationsastofuturedevelopments.
BackgroundTheresponsibilityfortheassessmentandprovisionofcommunityequipmentandminoradaptationsisaLocalAuthorityresponsibilityundertheChronicallySickandDisabledPersonsAct1970.
TraditionallymostLocalAuthoritiesfundandmanagetheOccupationalTherapystaffwhoundertaketheassessmentsandprovisionofequipmentandminoradaptations.
InLancashirethefundingandmanagementofthisservicehadremainedwiththeNationalHealthService,althoughtheCountyCouncilprovidedsomeadditionalrecurrentandnonrecurrentfundingfortheservice.
LancashireCountyCouncilhasassumedresponsibilityforboththefundingandmanagementoftheservicefrom1April2008forthefollowingreasons:ThelegalresponsibilityforthisserviceisclearlyaLocalAuthoritystatutoryduty.
WaitingtimesforassessmentsinpartsoftheEastLancashireareahavebeenconsiderable.
-2-ThePrimaryCareTrust(PCT)CommissionersarelookingtotheOccupationalTherapy(OT)Servicetoprovidemorespecialistrehabilitationservices.
TheimplementationoftheSingleAssessmentProcessbytheCountyCouncilprovidesanidealopportunitytoincreasetheskillmixandbreadthofassessmentactivityundertakenbystaffwithintheDirectorate.
ThesuccessfulimplementationoftheReablementServiceprovidesanidealbuildingblockforintegratingassessmentsforcommunityequipmentserviceswithinthewiderassessmentandreablingpathways.
TheimplementationoftheCustomerServiceCentreandthedevelopmentofamorepro-activescreeningprocesswillprovideavaluableandconsistentresponsetoreferralsforassessmentforcommunityequipmentservicesacrosstheCounty.
SpeedyresponsestorequestsforcommunityequipmentwillbeafundamentalfeatureofthenewpreventativeandwellbeingservicethatistobedevelopedbytheDirectoratethatwillbeinitiallyaccessedbytheimplementationoftheGatewayDirectService.
ProjectUpdateHumanResourcesThesecondmentoftheOccupationalSeniorManagerfromtheEastLancashirePrimaryCareTrusthasbeenextendeduntil31August,2008.
ThissecondmenthasbeenamajorsuccessforthisprojectandtheCountyCouncilshouldconsiderwhetheritwishedtoemployaSeniorOccupationalTherapisttostrategicallymanagethisprocess.
ThreetemporaryOccupationalTherapistpoststoofferdaytodaysupportintheallocation,assessmentprocessandclinicaloversighthavenowbeenappointed.
ItprovedverydifficulttorecruittothesepostsduetothembeingofatemporarynatureandequallytotheshortageofqualifiedOccupationalTherapistsnationally.
TenadditionalReview,AssessmentandSupportOfficers(fivetemporaryandfivepermanent)havebeenappointedandarenowinpostalthoughthereweresomedelaysduetoredeploymentissues.
AllReviewandAssessmentSupportOfficerswithinEastLancashirehavebeentrainedtotheLevelofTrustedAssessorsFramework(LevelOne),andsomehavebeentrainedtoLevelTwowiththeexpectationthatthiswillbeextendedtoallRASOsinEastLancashire.
Thistrainingincreasesthenumberofpiecesofequipmentthattheycanassessandprovide/install.
AllReablementAssessmentstaffaretrainedtoLevelOneinEastLancashirewiththesimilarexpectationthattheywillprogresstoLevelTwo.
ActivityData.
AselfassessmenttoolhasbeendevelopedandtestedwithintheHyndburnareaandthishasprovedtobesuccessfulandplansarenowinplacetorollthisoutacrossallareasintheEast.
PeoplewhohavebeenreferredtotheDirectorateforanassessmentforcommunityequipmentaresentaselfassessmentquestionnaire.
Onthecompletionandreturnofthequestionnaire-3-theindividualistelephonedbyoneoftheDirectorate'sOccupationalTherapistandifpossibleandappropriatethepieceofequipmentisorderedafterthephonecallthusnegatingtheneedforahomevisitTheAdultandCommunityServicesDirectoratebegantoreceiveallreferralsforassessmentsforCommunityEquipmentServicesfrom1May2008.
Theanalysisfromthefirstmonth'sdatademonstratesthateveninthefirstmonthofimplementationthenumbersofanticipatedreferralsdirectedtothePrimaryCareTrustforspecialiseOccupationalTherapyassessmentsisfarlessthanthepredicted310permonth,andthisbodeswellforthefutureoftheproject.
NumberofreferralsAllocationtoRASoAllocationtoPCTSelfassessment/OTA&CSscreeningAllocationtoOTfromHousingassociationsHynburn95173840RibbleValley56201422Rossendale10330302518Burnley10637362310Pendle86382721Totals44614214513128Total%31.
8%32.
5%29.
3%6.
2%AServiceLevelAgreementhasbeendraftedandisreadyforsignaturebetweentheCountyCouncilandtheEastLancashirePrimaryCareTrustregardingthenumbersofassessmentsandqualitycontrolissuesthattheCountyCouncilwillbuyfromthePCTforthefirstyearofoperation.
ApilotonutilisingaretailmodelfortheprovisionofequipmentbasedonaprescriptionservicewhichwillincreasechoiceandcontrolforserviceuserswillcommenceinJuly,2008.
ThispilotisoverseenbytheDepartmentofHealthandLancashireisoneofthefourpilotsitesintheNorthWestregion.
Thefundamentalbasisofthispilotisthatonceaserviceuserhasbeenassessedforapieceofequipmenttheywillbegivenaprescriptionfortheequipmentthattheycanuseatanyaccreditedproviderofequipmentservices(therearecurrently13providersinEastLancashire).
ThismeanstheServiceUserhasgreaterchoiceoftheprovisionoftheequipmentandcandecidetousetheirownfundsiftheywishtobuyamoreexpensiveversionofthepieceofequipment,Workisstillinprogresstodevelopawebbasedselfassessmentsystemwhichwillallowthemtonavigatearoundasimulatedhouseonscreenandbegivendirectadviceonthetypeofequipmenttheywouldneed.
TheutilisationoftheSingleAssessmentFrameworkmeansthatinmanycasesindividualshaveonepersonassessingtheirneedforservices,whereaspreviouslythreepeoplewouldhaveundertakenthreeseparateassessmentsoveraprolongedperiodoftime,andequallybeneficiallyonepersoncanarrangethreeserviceswhichwouldhavebeenarrangedbythreedifferentpeople.
Thisprovidesamoreseamlesslessfragmentedandpersoncentredcareapproachtotheassessmentofneedandthemeetingofneed.
-4-TheutilisationoftheTrustedAssessorsFrameworkisanationalaccreditedframeworkfortrainingnonqualifiedstaffinthesafeassessmentandprovisionofcommunityequipmentservices.
KeyEarlyLessons.
DespitesizeableorganisationaldifficultiesthetransferoftheresponsibilityforthisservicefromthePrimaryCareTrusttotheLocalAuthorityhasgonerelativelysmoothly.
ThedevelopmentoftheProjecthasassistedwithdeliveringamorepersoncentred,lessduplicativeandfragmentedserviceforthepeopleserved.
Itisdifficulttorecruittomanagerialandclinicalsupportpostsonatemporarybasis.
TheadditionalnumbersofReviewAssessmentsandSupportOfficersneededlongtermforthisProjectwasbasedontheassumptionthattheCountyCouncilwouldraisetheFACSthresholdtoSubstantial.
TheCountyCouncilhasnottakenthisaction,andthiswillmeanagreaterprojecteddemandforassessmentsandprovisionthanwasplanned.
ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:-5-LocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtReporttoCabinetMemberforAdultandCommunityServices-TheTransferfortheResponsibilityoftheManagementandFundingofAssessmentsforSocialCareEquipmentfromtheEastLancashirePrimaryCareTrusttoLancashireCountyCouncil30January2008JoanneMills/AdultandCommunityServices/34284ReasonforinclusioninPartII,ifappropriateN/AAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
6ElectoralDivisionaffected:NoneLancashireTeachingHospitalsFoundationNHSTrust-MaternityServicesReview(Appendix'A'refers)Contactforfurtherinformation:MelOrmesher(01772)536659,OfficeoftheChiefExecutiveExecutiveSummaryLancashireTeachingHospitalsFoundationNHSTrusthascarriedoutareviewofitsmaternityservicesinordertoprovidemoreequitableprovisionforwomeninPreston,ChorleyandSouthRibble.
AbriefoftheproposalstoreconfigurecanbefoundatAppendix'A'.
RecommendationTheCommitteeisaskedtoconsiderandcommentontheproposaltoreconfigurematernityservicesatLancashireTeachingHospitals.
BackgroundLancashireTeachingHospitalsFoundationNHSTrustrunsChorleyandSouthRibbleHospitalandRoyalPrestonHospitalprovidingmaternityservicesatbothsites.
RepresentativesoftheTrustwillpresentareviewofthecurrentmaternityservices,includingstaffandserviceuserconsultation,andtheproposaltoreconfigureprovision.
Theprimaryaimofthereviewintomaternitycareistodevelopservicesinsuchawayastoensuretheprovisionofasafe,equitablematernityserviceforallwomeninPreston,ChorleyandSouthRibble.
Thekeyproposalsinclude:RetentionandpromotionofChorleyBirthCentrePromotionofchoiceforallwomenwithintheparametersofsafetyEnhancementof1:1careforallwomenduringlabourProvisionofoptimalcareforvulnerablewomen.
DetailsofthematernityservicesreviewcanbefoundatAppendix'A'.
--2ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtReportoftheAdultSocialCareandHealthCommitteeSteeringGroup15April2008MelOrmesher/OCE/01772536659ReasonforinclusioninPartII,ifappropriateN/A-1-LancashireTeachingHospitalsNHSFoundationTrustMaternityServicesReviewThedevelopmentsinmaternityservicesatanationallevelaredrivenby,andfocussedaroundtherecommendationsmadeinthe'NSF'and'MaternityMatters'.
Eachhighlightstheneedtoprovideasafe,highquality,flexibleservicedesignedtomeettheindividualneedsofwomen,withparticularemphasisbeingplacedontheprovisionofchoiceinrelationtotypeandplaceofcarewherethisisappropriate.
Theissueofchoicewithintheparametersofsafetyisalsoidentifiedasakeyprioritywithin'MakingItBetterForMotherandBaby';therecommendationbeingthattheoptionofgivingbirthinalocalfacility,suchasadesignatedmidwiferyunitbeavailableforallwomenwherethistypeofcareisconsideredtobeappropriate.
Theprimaryaimofthereviewintomaternitycareisthedevelopmentofservicesinsuchawayastoensuretheprovisionofasafe,equitablematernityserviceforallwomeninPreston,ChorleyandSouthRibble.
Summaryofkeyproposals:RetentionandpromotionofChorleyBirthCentre(CBC)PromotionofchoiceforallwomenwithintheparametersofsafetyEnhancementof1:1careforallwomenduringlabourProvisionofoptimalcareforvulnerablewomen.
Impactandkeyareasforchange:Theestablishmentofbookingclinicsinlocalcommunitiesasanalternativetothewoman'shomeorthehospital.
Thiswillequalisethebookingprocessforallwomen,facilitatecontinuityofcare,andaffordallwomentheopportunitytomeetamidwifeatanearlystageofpregnancytodiscussoptionsforcare.
Itwillalsoreducethetimemidwivesspendtravelling;timewhichwillbere-investedindirectpatientcare,resultinginanincreaseinthecontacttimethatwomenareaffordedatthebookingconsultation.
RedistributingworkloadwillalsoreleasemidwivestorotateintothedeliverysuitewithintheSharoeGreenUnit(SGU)fordefinedperiodsfordevelopmental/updatingpurposes,ensuringthatmidwivesmaintainskillsandexposuretointrapartum(labouranddelivery)care,andtheeffectiverecognitionandmanagementofintrapartumemergenciesItwillhavetheaddedbenefitofincreasingthenumberofmidwivesavailablewithinthisarea,contributingtotheprovisionofsafecare,andbringingimprovedopportunitiestooffer1:1careforwomenduringlabour.
Inthoseinstanceswhereitisfeltthatahomebookingvisitwillbebeneficial,provisionwillbemadeforthis.
Thescheduleof,andprocessfortheprovisionofantenatalcarewillremainunchanged.
Inthoseinstanceswherewomen'sGPsareinvolvedintheprovisionofroutineantenatalcare,thiswillcontinue.
Theintroductionofacoreteamofmidwivesprovidingcoveracrossbothhospitalsitessupportedbyteamandcommunitymidwives.
ThischangewillimpactonthewayCBCisstaffed;Amidwifeworkingwithasuitablytrained,competentMaternitySupportWorker(MSW)willcareforwomenduringthepostnatalperiod.
Twomidwives(oneofwhomwillbedeployedfromthecommunitysetting)willbeinattendanceforthedelivery.
Appendix'A'-2-Emphasiswillbeplacedonofferingallwomenachoiceinrelationtoplaceofbirth,whereveritisappropriatetodoso.
ThechoiceforlowriskwomenwillincludehomeandCBC,aswellastheconsultantunit.
ItisacknowledgedthatthereisconsiderableunderutilisationofthefacilityatChorley.
ThepromotionofCBCasanoptionalplacefordeliveryforthosewomenwhobooktoreceivecareattheTrust,andwhomeettheclinicalcriteria(regardlessofplaceofresidence),will,itisenvisaged,increasetheutilisationofthisfacility.
Anevaluationofthemodelwilltakeplaceaftersixmonths.
Futuredevelopments:Theestablishmentofpostnatalclinicswithinthecommunitysetting.
Oneofthenationalchoiceguaranteesdescribedin'MaternityMatters'relatestochoiceofplaceofpostnatalcare,thestandardbeingthatwomenwillchoosehowandwheretoaccesspostnatalcare.
Itisspecifiedthatcareshouldbeprovidedeitheratthewoman'shomeorinacommunitysetting,suchasChildren'sCentres.
Theestablishmentofpostnatalclinicswithinthecommunitysettingwillofferwomenmorechoiceandaccessibilitytocare.
Midwives,supportedbyMSWswilldelivercareinaccordancewithwomen'sindividualneeds.
Theenhancementofmaternitycareforvulnerablewomen.
Theuniqueneedsthatvulnerablewomenhavearewelldefinedanddocumented,andthereisarecognisedneedtohaveanidentifiedclinicallead.
Thedevelopmentofaclinicalleadforvulnerablewomenmidwiferypostwillprovideleadershipandsupportformidwivesinthisarea.
Workforcechange:TheproposedchangeswillensureastandardisedservicemodelformaternitycarethroughouttheTrust,facilitateimprovedcontinuityofcare,andenhancetheeffectiveutilisationofstaffacrossallareas.
ThewayinwhichmidwiferycareiscurrentlydeliveredatCBChasimpactedoncontinuityofcarewithinthecommunitysetting,asmidwivesfromthecommunityworkforcesupportstaffwithintheunittoprovidetheagreedlevelofcover.
Itisenvisagedthatadedicatedintrapartumteamwillrelievepressurefromcommunitymidwives,therebyenablingthemtofocusonprovidinghighqualityantenatal,intrapartumandpostnatalcarewithinthecommunitysetting.
EachcommunitymidwifewillspendfourcontinuousweeksworkingontheSGU'sdeliverysuitetoensureexposuretointrapartumcare,andtheeffectiverecognitionandmanagementofintrapartumemergencies.
Benefitsofthechanges:Theproposedchangeswillresultinamorestreamlinedpathwayofcare,willreducerisktowomenandtheirbabies,willimprovecontinuityofcareandincreasechoiceandsatisfaction.
Theworkforcewillbeworkingmoreefficiently,therebyensuringthatmidwivesareintherightplace,attherighttimetodeliverasafe,highquality,equitableandeffectivematernityservice.
Consultationwithstakeholders:ConsultationwithCentralLancashirePrimaryCareTrust(PCT)hasbeenongoing.
Theyaresupportiveoftheprinciplesdetailedwithintheproposals,andhavebeenactivelyinvolvedintheconsultationthathastakenplacewithserviceusers.
-3-AdetailedMaternityReviewConsultationPaperwascirculatedtostaffon29thApril2008,andpresentedataseriesofstaffmeetingsheldacrossbothhospitalsitesbetween30thApril2008and6thMay2008.
Inadditiontoseniorclinicalandmanagerialrepresentatives,representativesfromtheHumanResourcesdepartmentattendedallmeetingsforthepurposeofadvisingstaffonhumanresourceissues.
Commentssheetsareavailablebothelectronically,andinpaperformat,andstaffarebeingencouragedtoreturncommentsandsuggestionspriortotheconclusionoftheconsultationperiodon23rdJuly2008.
Aseriesofconsultationevents(jointlyundertakenbyLancashireTeachingHospitalsNHSFoundationTrustandCentralLancashirePCT)havetakenplaceinordertoascertaintheviewsofserviceuserstotheproposedchanges.
Atotalof7events,involving69servicesusers(46womenand23men)havebeencarriedout.
Theformatoftheeventshasincludedbothgroupandindividualdiscussion,and,inordertogainabroadspectrumofviews,theconsultationmeetingswereundertakenwithwomenandcouplesattendingparenteducationsessionandantenatalclinicappointmentsatbothhospitalsites(RoyalPrestonHospitalandChorleyDistrictHospital),andwithagroupofwomenatalocalChildren'sCentre.
Theinformationprovidedinrelationtothegeneralexperiencesandexpectationsofserviceusers,aswellastheirviewsonthespecificchangestoservicedeliverythathavebeenproposedwithintheMaternityServicesReviewhasbeeninformative.
Briefdetailsofthefeedbackrelevanttotheproposedchangesaredetailedbelow:BookingclinicsAsanticipated,therewasadisparityintheexperiencesofwomeninrelationtowheretheyhadbeenbookedformaternitycare.
Serviceusersreactedfavourablytotheproposedchangesinrelationtotheestablishmentofbookingclinicswithinthecommunitysetting,suggestingthatitisnotthevenue,butrathertheexperienceitselfthatdeterminesthevalueoftheconsultation.
Eventhosewhohadbeenbookedintheirownhomes,andwhodescribeditasapositiveexperienceappreciatedtheneedforuniformityinrelationtoserviceprovision,andrecognisedthepotentialbenefitsthatcouldberealisedwiththeintroductionofthischangetoservicedelivery.
Theimportancethatwomenandtheirpartnersplacedonthereceivingofrelevantinformationatanearlystageofpregnancywasapparentthroughouttheconsultation.
This,togetherwithcontinuityofcareandcarerduringtheantenatalperiodwasidentifiedasbeingfundamentallyimportanttowomenandtheirpartners;theyidentifiedclearbenefitsinmeetingamidwifeearlyinpregnancy,andinseeingthatsamemidwifeonaregularbasis,therebyenablingrelationshipsoftrusttobeestablished.
Giventhatoneoftheperceivedbenefitsoftheproposalsisanimprovementincontinuityofcare,theintroductionofthisservicemodelshouldhaveclearlyidentifiablebenefitsinthisarea.
ChoiceAvastmajorityofthosequestionedstatedthattheyhadbeenofferedchoicesregardingwhethertodeliverinhospitalorathomeunlesstherewasanidentifiedreasonwhyitwasnecessaryforthemtodeliverattheSGUunderthecareofaconsultant.
However,onlyasmallproportionofthoselivingwithinthePrestonareahadbeengiventheoptionofdeliveringatCBC.
Thisclearlysuggeststhatfurtherworkisrequiredtopromotethisasarealoptionforalllowriskwomen.
Itissuggestedthatimprovedintegrationbetweenstaffworkingacrossbothsiteswillfacilitatethis.
Theissueofinformationimpactingonwomen'sabilitytomakechoiceswasalsoidentified;onewomanmadetheimportantpointthat,inordertomakechoices,womenmustbearmedwithsufficientinformation.
Thisagainsupportstheproposedservicechange,whichisdesignedtoenablewomentomeetmidwivesatanearlystageofpregnancyandtoimproveaccesstoamidwifeatalocallevel,thereby-4-facilitatingwomentoobtaininformationinatimelymannertoenablethemtomakeinformedchoices.
IntroductionofacoreintrapartumteamWhilsttheissueofintroducingonecoreintrapartumteam,workingacrossbothsitesdidnotevokeasmuchreactionassomeoftheotherissues,safety,particularlyduringlabouranddeliverywasobviouslyofrelevanceandimportanttoallserviceusers.
Allofthoseconsultedappreciatedthebenefitsofoperatingaserviceinwhichateamofmidwiveswhoareskilledinintrapartumcareandinmanagingemergencysituationsworkacrossbothsites.
Manyofthosewhocommentedmadethepointthatitisrelativelyunimportantforthemtoknowthemidwifewhowillprovidecareduringlabouranddelivery.
However,thebenefitsofachieving1:1careinlabourwasclearlyappreciatedandsupported.
Conclusion:Theintroductionofarevisedcarepathwayasdescribedwithintheproposal,whichisnotasignificantservicechangewillstrengthentheservice,andalignittonationalguidelines.
Mostimportantly,itwillfacilitatetheprovisionofaservicethatmeetstheneedsandexpectationsofwomenwithinthePreston,ChorleyandSouthRibblelocalities.
AdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingbeheldon8July2008PartI-ItemNo.
7ElectoralDivisionaffected:AllLocalInvolvementNetworks(LINks)ProgressContactforfurtherinformation:JonGarnett,(01772)531897,AdultandCommunityServicesDirectorateJon.
garnett@ssd.
lancscc.
gov.
ukExecutiveSummaryFollowingthesubmissionofareportonthedevelopmentofLocalInvolvementNetworks(LINks)inLancashiretotheAdultSocialCareandHealthOverviewandScrutinyCommitteeon27May2008,itwasagreedthatafurtherreportonthedevelopmentofLINksbepresentedtothenextmeetingoftheCommitteeandtofuturemeetingsasnecessary.
ThisreportgivesanupdateontheprocurementexercisefortheappointmentofthefulltimeHostorganisationandactivitycarriedouttopromotetheLINkduringthetransitionalperiod.
RecommendationTheAdultSocialCareandHealthOverviewandScrutinyCommitteeisaskedtoreceiveandcommentontheupdatereport.
BackgroundLocalInvolvementNetworksarebeingdevelopedtocreatealocalsystemwhereeverycitizen,fromeverysectionofthecommunity,hastheopportunitytosaywhattheywantfromtheirlocalcareservices,withtheknowledgethatthepeoplewhoplanandrunthemwilllistenandrespond.
OurHealth,OurCare,OurSay2006andAStrongerVoice2006havepreparedthewayforTheLocalGovernmentandPublicInvolvementinHealthAct2007toendPatientandPublicInvolvementForumsasof31March2008.
TheywillbereplacedbyLocalInvolvementNetworks(LINks),whichwilldeveloptheroletocoverbothHealthandSocialCare.
TheActrequiresLocalAuthoritieswithSocialservicesresponsibilitiestocontractwithaHostorganisationforathreeyearperiod,todeliverLocalInvolvementNetworks(LINks),intheirgeographicalarea.
Thisisastatutoryresponsibility.
-2-LancashireCountyCouncilhasbeencarryingouttheprocurementprocesstoappointaHostorganisationtosupporttheLINkinitsactivity,progresssofarincludes:Shortlistingofbids2June2008Interviewswithpotentialproviders6June2008PreferredProvideridentifiedBlackHealthAgencyarethesuccessfulapplicantsforthepermanentLINkscontract.
DuringtheTransitionperiodwhichrunsfrom1April2008until31July2008,theBlackHealthAgencyhasbeenundertakingworkinpartnershipwiththeinterimLINksAdvisoryboard.
Thefocushasbeenupondevelopingpublicparticipationanddeliveringroad-showstopromotetheLINk.
TheAdvisoryBoard,withmembersdrawnfromtheNHS,LocalAuthority,formerPatientandPublicInvolvementForummembersandrepresentativesofsocialcareandpartnershipsandcommunitygroups,willbechairedbytheLocalAuthorityuntiltheendoftheinterimperiod.
Worktofollowincludes:HandoveroftheAdvisoryBoardtoparticipantsDevelopmentofgovernance,structuresandprotocolsMembersoftheAdvisoryBoardtobeelectedandrepresentativeofthecommunityandabletoworkwiththeappointedHostorganisationtodevelopappropriatemethodsofengagement.
SetoutbelowistheLancashireLINkpromotionalworkundertakenbyBlackHealthAgency(BHA).
TheLancashireLocalInvolvementNetwork(LINk)iscurrentlyinitsdevelopmentstageandBHAisworkingwithLancashireCountyCounciltoraiseawarenessofthenewLancashireLINk.
BHAisacharitydedicatedtochallenginghealthinequalitiesandsupportingandenablingcommunitiestotakeactiontoimprovetheirhealthandwellbeing.
BHAprovidesandsupportshealthrelatedservicesandprojectsthroughouttheNorthWestandpreviouslysupportedmanyPatientandPublicInvolvement(PPI)ForumsintheNorthWestincluding,inLancashire,CentralLancashirePCTPPIForum,LancashireTeachingHospitalsNHSFoundationTrustPPIForum,LancashireCarePPIForumandtheNorthWestAmbulanceServicePPIForum.
ThepurposeofourLancashireLINkpromotionalworkistoraiseawarenessandencourageinvolvement.
Thenatureoftheworkhasbeen:1.
Toproduceanddistributepromotionalmaterials(leaflet,flyers,newsletters,presentations,banners).
ElectroniccopieshavebeenprovidedforLancashirecountycouncillorsandalllocalauthoritycouncillorsintheLancashireLINkarea.
2.
Toorganiseandfacilitatethefirstthreeworkshopsinaroadshowofworkshops/eventsagreedbyLancashireCountyCouncil'sTransitionalAdvisory-3-Board.
ThesearetakingplaceinLytham(24June),Burnley(26June)andPreston(2July).
Separateinvitationflyershavebeenproducedforeacharea,aswellasacombinedflyerforLancashire-wideorganisationsgivingthedetailsofallthreeevents.
3.
ToorganiseandfacilitateaworkshopforformerPPIForummembers.
Thistookplaceon12June2008atCountyHallwith21formerPPImembersparticipating.
4.
Toconductfacetofacemeetingswithorganisationsandkeyinvolvementworkers,tointroducethemtotheLancashireLINk,encouragethemtogetinvolvedandseektheirviewsonwhattheLINkneedstodo:toinvolvepeopleandgroups,retainitsindependenceandfunctioneffectively.
Thisdiscussionwillbethefocusofalltheworkshops(see2and3above),withsomestructuredquestionstofacilitatethedebate.
5.
Toorganiseawidedistributionofleaflets,newslettersandworkshopinvitationsthroughouttheLancashireLINkgeographicalarea,usingexistingnetworksandgroups(thirdsectorandstatutory)andcontactsmadebythepromotionteam.
6.
Toattendedlocaleventsandcarryoutpresentationstogroups,conferencesandmeetingsasrequested.
Thefocusofourworknowwillbetocontinuethedistributionofpromotionalmaterials,conductfacetofacemeetings,attendevents,givepresentationsasinvited,facilitatetheworkshopsandrecordcommentsandconclusionsfromeachone.
FollowingtheworkshopsasummaryreportwillbepreparedtoLancashireCountyCouncil'sTransitionalAdvisoryBoardontheworkwehavecarriedout,includingtheviewsgatheredfromthecommunityandsuggestedmodelsofworking.
ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:-4-LocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtReporttoAdultSocialCareandHealthOverviewandScrutinyCommittee–DevelopmentofLocalInvolvementNetworks(LINks)27May2008MelOrmesher/OfficeoftheChiefExecutive/36659ReasonforinclusioninPartII,ifappropriateN/AAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
8ElectoralDivisionaffected:AllReportoftheEquitableAccessinPrimaryMedicalCareProcurementTaskGroupsContactforfurtherinformation:MelOrmesher,(01772)536659,OfficeoftheChiefExecutiveExecutiveSummaryTheimprovementofaccesstoprimarycareisakeypriorityfortheNHSin2008,andwillbedeliveredthroughtheEquitableAccesstoPrimaryMedicalCareprogramme.
TheprogrammeaimstobuilduponexistingPrimaryCareTrustprioritiesfordevelopinglocalhealthcareservicesandtoensurepublicinvolvementintheprocess.
3taskgroupsmettoconsiderthedevelopmentoftheEAPMCprogrammeineachofLancashire's3PrimaryCareTrusts(Central,EastandNorth)andtoanswerspecificquestionsasfollows:1.
CommentonthescopeoftheprogrammeineachPCTarea2.
Adviseonthedevelopmentoflocalengagementprocesses3.
Giveviewsonthepotentiallocationofnewservices4.
AdviseonmeasuringthepotentialimpactonthewiderhealthcommunityRecommendationTheCommitteeisaskedtoapprovetherecommendationsofthetaskgroupsastheyapplytoeachPrimaryCareTrustinthereport.
BackgroundTheNHSNextStageReviewInterimReport(October2007)carriedoutbyLordDarzi,reportedthatdespiteinvestmentoverthelast10years,accesstoandqualityofprimarymedicalservicescontinuestovarysignificantlyacrossthecountry.
Manyofthepoorestcommunitiesexperiencethegreatesthealthinequalitieswiththegapinlifeexpectancywideningbetweenthemostdeprivedandmostaffluentareas.
-2-Consequently,theEquitableAccesstoPrimaryMedicalCareprogrammewasannouncedbythegovernmentinDecember2007tobedeliveredin2008/9.
Fundingof250millionwillbeprovidednationallytosupportPCTsto:procurenewGPpracticesprocureGPledhealthcentresenableexendedopeninginsomeGPpracticesexpandgeneralpracticeandhealthcentreservicesTheDirectorsofCommissioningfromCentral,EastandNorthLancashirePrimaryCareTrustsgaveapresentationtotheAdultSocialCareandHealthCommitteeon15April2008whereitwasresolvedtorequest3taskgroupsbeestablishedtoconsiderthedevelopmentoftheEAPMCprogrammewithineachPCT.
ManagementCommitteeapprovedtherequeston9May2008.
RepresentativesofeachPCTattendedtherespectivetaskgrouptogiveafurtheroverviewoftheEAPMCprogramme.
Theoriginalreportsubmittedtocommitteeandconsideredinthetaskgroupscanbefoundat:http://www.
lancashire.
gov.
uk/council/meetings/displayAgendas.
aspmeetid=5103Eachtaskgroupaimedtoconsiderandadviseonthefollowing4questions:1.
CommentonthescopeoftheprogrammeineachPCTarea2.
Adviseonthedevelopmentoflocalengagementprocesses3.
Giveviewsonthepotentiallocationofnewservices4.
AdviseonmeasuringthepotentialimpactonthewiderhealthcommunityResponsestothesequestionscanbefoundintheformofrecommendationsrelevanttoeachrespectivePCTbelow.
CentralLancashirePrimaryCareTrustThetaskgroupconsideringtheEAPMCprogrammeinCLPCTconsistedofCountyCouncillorsTimOrmrod(chairperson),RobertPendleton,FrankDeMolfetta,MaryWilson,andDistrictCouncillorDoreenStephenson.
DoreenHounslea,DirectorofCommissioningandCommunityEngagement,PeterTinson,AssociateDirector,SteveWard,MedicalDirector,andChristineWalton–HeadofGPContractingfromCLPCTattendedthemeetingtogiveanoverviewoftheprogrammeandhowitwouldbedeveloped.
InCLPCTseveralpatientsurveysdemonstratedthattherewerenosignificantissuesregardingaccesstoprimarycare,buttherewasnowthepossibilitytoimproveandbuildonexistingservices.
Tomakeaccessmoreequitabletherewouldbe3PrimaryCareAccessCentresinthelocalitiesofPreston,ChorleyandSouthRibble(tobedetermined)andWestLancashire(potentiallyOrmskirkDistrictHospital).
Thenewcentreswouldaimtoincorporate:urgentcare,extendedprimarycareservices,dentalprovision,opticalservices,pharmacy,andinnovativeservicesthatwouldcomplementtheservicesproposedandbecosteffectiveandallprovidedwithina24-3-hourpackage.
Appointmentsbothscheduledandnon-scheduledwillbeavailablewiththeaimofrelievingA&Edepartmentsbycarryingoutminorprocedures.
Workwillbeongoingtodeliverthegovernmenttargetof50%ofGPpracticesofferingextendedopeninghours.
TheEAPMCtaskgroupforCentralLancashirePCTmadethefollowingrecommendations,that:i)CentralLancashirePrimaryCareTrustshouldensurethatnewservicesareaccessiblebypublictransportanditshouldbeexplicitintheprocurementprocessthatprovidersexplainhowtheservicewillbeadvertisedandaccessed.
ThePCTshouldensureclinicalsupportfortheprogrammeandaddressrecruitmentandstaffretentionissues.
Thehospitaltrustsshouldbeengagedtodevelopsignpostingtoappropriateservicesandensureclearpatientpathwaysandservicecontinuity.
ii)CLPCTshouldusecreativeengagementmechanismssuchastargetedmailings,LINks,andoutreachingintothecommunity.
ThereshouldbeaclearmessagecommunicatedabouthowtoaccesstherightserviceattherightsiteandtopromotetheconceptofthePrimaryCareAccessCentre.
iii)CLPCTshouldavoidtheduplicationofservicesandensuregoodaccesstoprimarycareacrossthewholeofcentralLancashire.
iv)CLPCTshouldensurethatthehospitaltrustsareinvolvedintheprocessofrefiningplannedsecondarycareinlightofenhancedprimarycare.
EastLancashirePrimaryCareTrustThetaskgroupconsideringtheEAPMCprogrammeinEastLancashirePrimaryCareTrustconsistedofCountyCouncillorMaureenMartin(chairperson),RobertPendleton,MilesParkinson,MikeCalvertandDistrictCouncillorColinCoulton.
CathGalaska,DirectorofStrategicCommissioning,andPeterSellars,HeadofPrimaryCareCommissioning,fromELPCTattendedthemeetingtogiveandoverviewoftheprogrammeandhowitwouldbedeveloped.
InEastLancashire,anewGPpracticewillbelocatedacross3sitesinNelson,BurnleyandRawtenstall(providingforaregisteredlistof6000patients)withextendedopeninghours.
AnewGP-ledHealthCentrewillbesitedalongsidetheUrgentCareCentreatVictoriaHospital,Accrington.
Workwillbeongoingtodeliverthegovernmenttargetof50%ofGPpracticesofferingextendedopeninghours.
Followingdiscussion,memberswelcomedtheprogramme,andapplaudedtheinvestmenttocontributetohealthylivingineastLancashire.
TheEAPMCtaskgroupforEastLancashirePCTmadethefollowingrecommendations,that:-4-i)ELPCTshouldensurethatnewservicesareaccessiblebypublictransportanditshouldbeexplicitintheprocurementprocessthatprovidersexplainhowtheservicewillbeadvertisedandaccessed.
ii)Inordertoeffectivelyengagewithawidespectrumofpeopleandcommunicatetheserviceimprovementstobedelivered,ELPCTshould;ensureappropriatemethodsandmediaforcommunicationsmaterialandgoodcoverageineachareathatistobenefitfromtheprogramme,learnfromtheMeetingPatientsNeedsprogramme,andencouragehealthservicestafftoactasadvocatesfordevelopments.
Whilsttheuseofaprofessionalpublicrelationscompanyiswelcomed,creativewaysofsharinginformationshouldbeencouragedsuchasthroughLancashireCountyCouncilservices,viacouncillorsatcountyanddistrictcouncils,throughstrategicpartnerships,andusingnewtechnologysuchas'texting'totargetyoungpeople.
ThePCTshouldbepro-activeingettinginformationnotonlytoserviceusersbutpotentialuserssuchasyoungpeople.
iii)ELPCTshoulddevelopaframeworktoidentifyappropriatesitesincorporatingdeprivationlevelsandhealthinequalities,whilstmakingbestuseofexistingservices.
Thepublicshouldbekeptinformedofdevelopmentstoenabletheirsupport.
iv)ELPCTshouldincludeappropriateperformanceindicatorsrelatingtolocalhealthneedsinserviceprovidercontractstoensureproviderscontributetoaddressinghealthinequalities.
NorthLancashirePrimaryCareTrustThetaskgroupconsideringtheEAPMCprogrammeinNLPCTconsistedofCountyCouncillorPennyMartin(chairperson),RobertPendleton,AlbertThornton,ValerieWilsonandDistrictCouncillorColinCoulton.
KevinMcGee,DirectorofCommissioning&PerformanceManagement,DrJimGardner,MedicalDirector,ClareWild,HeadofPrimaryCare,andAndrewBennett,AssistantDirectorCommissioningBusinessServicefromNLPCTattendedthemeetingtogiveandoverviewoftheprogrammeandhowitwouldbedeveloped.
AGP-ledHealthCentrewillbeprocuredinFleetwoodtoprovideextendedservices8amto8pm7days/week.
Nositeisspecifiedforthisservice.
NewGPpracticeswillbelocatedinHeyshamandThorntonwithCleveleys.
ThepracticeinHeyshamwillbeexpectedtodelivercoreGPservices,additionalandlocalenhancedservices,engageinPracticeBasedCommissioning,provideextendedopeninghours,extendedpracticeboundary,alongwithageneraldentalpracticetobeincludedwithalinktothenewdentaltrainingschool.
AsthisprogrammewillbedeliveredthroughnewmoneythePCTbelievethereshouldbenoextractionfromexistingservices.
Workwillbeongoingtodeliverthegovernmenttargetof50%ofGPpracticesofferingextendedopeninghours.
TheEAPMCtaskgroupforNorthLancashirePCTmadethefollowingrecommendations,that:-5-i)TheEAPMCprogrammeinNorthLancashireshouldnotonlyofferchoicebutprotectaccesstopatientsownGPs.
ii)NLPCTshouldensurethatnewservicesareaccessiblebypublictransportanditshouldbeexplicitintheprocurementprocessthatprovidersexplainhowtheservicewillbeadvertisedandaccessed.
Thereshouldbeconversationswithpartnerstodeveloptravelplansfornewbuildprojects.
iii)NLPCTshouldensuremeaningfulandaccuratecommunicationswiththepublic,includingthosewhodonotregularlyattendsurgeries,beforeandaftertheprocurementprogramme.
Tendersshoulddemonstratehowserviceproviderswillengageandcommunicatewithpatients.
iv)Whilstassessingthebenefitsoftheprogrammewilltakemanyyears,thereshouldbenonegativeimpactonthewiderhealtheconomyasaresultofdivertingfundsintoprimarycare.
v)NLPCTshouldensurethedrivetopromotehealthcareandaddresshealthinequalitiescontributestoreducingpovertyanddeprivation.
vi)NLPCTshouldincludeappropriateperformanceindicatorsrelatingtolocalhealthneedsinserviceprovidercontractstoensureproviderscontributetoaddressinghealthinequalities.
ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtEquitableAccesstoPrimaryCareProcurement15April2008MelOrmesher/OfficeoftheChiefExecutive/01772536659ReasonforinclusioninPartII,ifappropriate-N/AAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
9ElectoralDivisionaffected:AllConsultationontheFutureofTobaccoControl(Appendix'A'refers)Contactforfurtherinformation:MelOrmesher,(01772)536659,OfficeoftheChiefExecutiveExecutiveSummaryTheAdultSocialCareandHealthCommitteeareinvitedtoconsideraconsultationdocumentonTheFutureofTobaccoControl,andagreehowtheywouldwishtorespond.
RecommendationTheCommitteeisaskedtoconsidertheestablishmentofa"responsegroup"tocontributetoLancashireCountyCouncilscorporateresponsetotheconsultation.
BackgroundTheCancerReformStrategy2007gavetheGovernment'sintentiontoconsultonthenextstepsintobaccocontrol,furtherregulationoftobaccoproducts,andwithstakeholdersonmeasurestoreducethesignificantharmtohealthcausedbysmokingforthosewhoareaddictedtonicotineandnotabletoquit.
Theconsultationwaslaunchedon31May2008andcloseson8September,thedocumentcanbefoundat:http://www.
dh.
gov.
uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085114Itisthestartofthedevelopmentofanationaltobaccocontrolstrategyandcoversanumberofspecificareas:ReducingsmokingratesandhealthinequalitiescausedbysmokingProtectingchildrenandyoungpeoplefromsmokingSupportingsmokerstoquitHelpingthosewhocannotquit-2-TheAdultSocialCareandHealthCommitteeareinvitedtoreadandconsidertheconsultationdocumentanddecidehowtheywouldwishtorespond.
Itisproposedthat,inordertodraftaresponse,theAdultSocialCareandHealthCommitteesubmitarequesttotheManagementCommitteeinordertosetupa"ResponseGroup".
Theresponsegrouptoconsistof3membersofthecommittee,selectedatthemeetingfrommembersexpressinganinterest,andcontributetotheCountyCouncilscorporateresponse.
ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtN/AReasonforinclusioninPartII,ifappropriateN/AAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
10ElectoralDivisionaffected:AllConsiderationoftheForwardPlan(Appendix'A'refers)Contactforfurtherinformation:MelOrmesher,(01772)536659,OfficeoftheChiefExecutiveExecutiveSummaryAtitsmeetingon23February2007,theOverviewandScrutinyManagementCommitteeagreedthatallCommitteesshouldbepresentedwiththelatestForwardPlanateverymeeting,inorderthattheymayconsiderthosedecisionsthatarerelevanttotheirareaofwork.
TheForwardPlanforJulytoOctober2008,insofarasitrelatestothosedecisionsthatarerelevanttotheCommittee'sareaofwork,isattachedatAppendix'A'.
ThefullForwardPlanisavailableontheDemocraticInformationSystemwebsite:http://www.
lancashire.
gov.
uk/council/meetings/forwardPlanOfKeyDecisions.
aspRecommendationTheCommitteeisaskedtoconsiderwhetheritwishestoreviewanyoftheproposedExecutiveDecisions.
BackgroundTheForwardPlanispublishedeachmonth.
ItbrieflydescribesmatterslikelytobesubjecttoKeyDecisionsoverthenextfour-monthperiod.
AKeyDecisionforthispurposeisanExecutivedecisionthat:hasamaterialimpactwhetherinoneElectoralDivisionorasmallercommunity;withoutreferencetoanyfinancialthresholdordomesticdecisions(affectingtheinternalworkingsoftheCouncil)whichhaveafinancialimpactontheCouncilof1.
2mormore.
TheForwardPlanenablesthepublictoseewhatKeyDecisionsareinthepipeline,whowillbetakingthem,when,andwhatconsultationwilloccur.
-2-TheCommitteehaspreviouslyaskedthatapapercopyoftheForwardPlanbeprovidedwiththeAgendapapersforallmeetings.
Accordingly,theForwardPlanforJulytoOctober2008,insofarasitrelatestothosedecisionsthatarerelevanttotheCommittee'sareaofwork,isattachedatAppendix'A'.
TheInternetaddressis:http://www.
lancashire.
gov.
uk/council/meetings/forwardPlanOfKeyDecisions.
aspTheForwardPlancanalsobefoundbyclickingon"ForwardPlanofKeyDecisions"onthefrontpageoftheCountyCouncil'swebsite.
ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtMinutesoftheOverviewandScrutinyManagementCommittee23February2007JoshMynott,OfficeoftheChiefExecutiveExt.
34580ReasonforinclusioninPartII,ifappropriateN/AAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
11ElectoralDivisionaffected:NoneWorkPlanning2008/9(AppendicesAandBrefer)Contactforfurtherinformation:MelOrmesher,(01772)536659,OfficeoftheChiefExecutiveExecutiveSummaryTheAdultSocialCareandHealthOverviewandScrutinyCommitteeareinvitedtocommentonpossibletopicsforconsiderationbytheCommitteein2008/09,arisingoutoftheannualworkplanningconsultation.
RecommendationTheCommitteeisaskedtoconsiderandcommentonthetopicsproposed.
BackgroundInAprilandMay2008,awiderangeoforganisationsandindividualswerecontactedtoinvitethemtosubmitsuggestionsforscrutinyin2008/09.
TheresponsesrelatingtotheworkofthiscommitteeareattachedatAppendix'A'.
InadditionthecurrentagreedworkplanisattachedatAppendix'B'.
Thecommitteehasrobustarrangementsforworkplanningthroughouttheyear,andtheworkplanisstandingitemontheagenda,allowingmemberstoconsiderandcommentupontheworkofthecommitteeatanypoint.
Membersareinvitedtodiscussthetopicssuggested,aswellasproposingnewtopics.
DiscussionwillthentakeplacebetweentheChairanddeputiesandtherelevantofficerstodelivertheworkplanthecommitteerequest.
ConsultationsAwideconsultationtookplaceinvolving,amongstothers,countycouncillors,councildirectorates.
NHStrusts,Voluntary,CommunityandFaithSectorGroups,policeauthorityandservice,fireauthorityandservice,districtcouncils,andLSPs.
-2-AdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtN/AN/AN/AReasonforinclusioninPartII,ifappropriateN/AThefollowingisalistofthesuggestionsreceived.
Thewordingusedisexactlythatusedbythepersonwhosubmittedtherequest.
Viewsexpressedarethereforethoseoftheindividualssubmittingthesuggestion.
Wherethereareblankspaces,thisissimplybecausethesubmissionleftthatpartoftheformblank.
TheCommitteecolumnhasbeencompletedbyO&Sofficers,butsometopicscutacrossmorethanonecommittee,orarewithinonecommittee'sremitbutwithissuesofinteresttoanother.
Themajorityoftheseareindicatedbytheinclusionoftwocommitteenamesinthecolumn.
SuggestedTopicWhyshouldthistopicbereviewedCommitteeThepromotionofphysicalactivityamongallsectionsofthepopulationPhysicalactivityisimportanttothehealthandwellbeingofallagegroupsandpopulationswithinLancashire.
Thereisevidencethatlevelsofphysicalactivityhavereducedinrecentyearsandthishasimplicationsforhealthincludingimpactonchildobesity,adultmortalityandmorbidity,andcontinuedmobilityfortheelderly.
ThereisagreatdealthathealthandlocalauthorityorganisationswithinLancashirecandotoimprovetheopportunitiesandenvironmentwhichwillleadtoincreasedlevelsofphysicalactivityASCHHealthproofingofLancashire'splanningsystemsLocalauthorityplanningdecisionsinLancashirearerarelyinformedbyformalhealthimpactassessments.
INconsequence,Lancashireisfallingbehindtherestofthecountryinadoptionofbestpracticeandopportunitiestobuildhealthandwellbeingconsiderationsintomajorinfrastructuredevelopmentsacrossthiscountyarebeingmissed.
ConsiderationofthistopicbytheO&ScommitteecouldprovideasignificantdrivetoimprovetheplanningsystemandtoimprovehealthandwellbeingforthepopulationofLancashireASCH(C&P)TheeliminationofdelayofCarePackagestoElderClientsThedelayscausestresstothecaredforandalsotothecarersASCHAppendix'A'DemographicchangesinthepopulationofLancashire–HowLCCisgearingupforthelargeincreaseinolderpeopleandthecorrespondingdemandontheservicessupportingthesepeopleIfthevariousofficeswithinLCCdonotaddressthisproblemnowthenanylastminutesolutionswithinthenext10-210yearswillbemoreexpensiveifnotunsustainable.
ThereisalimittothemoniessuppliedthroughtaxationASCH/C&PDentalprovisionforchildrenASCH/CYPAgeneralreviewofOrganisationalAimsandObjectives(ofEastLancsPCT)ToprovideanUpdateASCHApresentationontheEastLancsHealthandWellbeingStrategy2008-11"AmillionYearsSaved"AmajorpieceofstrategicbusinessASCHLocalInvolvementNetworksAftersomemonthsofcontactwithanumberofVCFgroups,LCCtookaunilateraldecisiontoawardtheinterimhostcontracttoBlackHealthAgency.
Atnotimeduringdiscussions…thisoptionbeenexplored,letaloneagreedinpartnership.
ASCHNorthWestAmbulanceService-FoundationTrustStatusapplicationAtourTrustBoardinJanuary2008,NorthWestAmbulanceServicemadeadecisiontoapplyforFoundationTrustStatus.
WeexpectthatthiswillnotbebeforeApril2010,howeverasanorganisationwearefullycommittedtothebenefitsofFoundationTrustStatusandwhatthatcanofferforpatients,thepublic,localcommunitiesandourstaffaswellasimprovingourorganisationaldevelopment.
ASCHWewillbecontactingOverviewandScrutinycommitteesaswebeginourpreparationsforapplyingforFoundationTrustStatusandwewouldbehappytocomeandbriefOverviewandScrutinyCommitteesonourproposedplans.
NorthWestAmbulanceService–EstatesStrategyThetrusthasproducedanoutlineEstateStrategywhichsetsouttheprinciplesforustoassessourexistingbuildingsandtheirfuturefitnessforpurposetosupportourclinicalservicedeliveryandfuturedemandmanagement.
Wehavenowstartedareviewofexistingestates.
WerecognisethatthelocationsofAmbulanceStationscanattractlocalattentionandfeltthatwewantedtoensurescrutinycommitteesarefullyengagedbothonaNorthWestfootprintbutalsoonanyparticularlocaldiscussionsaswestarttoscopeoutourplans.
Althoughinprinciple,itisnotnecessarilythelocationofbuildingsthatmatterbutthedynamicdeploymentofourvehiclesintermsofensuringwereachpatientsasquicklyaspossible,wefeelthatitisimportantthatpublicperceptionistakenintoaccountaspartofourplanning.
Asadvised,wearestillintheearlystagesofundertakingareviewoftheexistingestatesbutwouldappreciatetheOSC'sinvolvementandengagementaswebegintodeveloporplans.
ASCHNorthWestAmbulanceService–PublicHealthStrategyNorthWestAmbulanceServiceisoneofthefirstAmbulanceTruststolaunchaPublicHealthStrategynationallyandwearefullycommittedtorealisingthekeyrolewecanhaveasacommunitybasedservice,inimprovingthehealthofthepopulationintheNorthWest.
TheroleoftheOSC'sandscrutinywouldbeofhugebenefitaswestarttodevelopthedifferentstrandsofourPublicHealthagendaandhowwecanhelptoreducehealthinequalitiesandcontributetohealthimprovementacrosstheNorthWest.
WewouldbegratefulfortheOCS'sinput,asappropriateas,ourplansdevelop.
ASCHACSRestructureToupdatemembersonhowACSisstructuredtocommissionanddeliverservicesSelfDirectedSupportsSDSputthepersonatthecentreofthecommunitywithcontinuinghealthcaredeliveredthroughapersonalbudget.
Howdoesthislinkthroughthetiersofcommissioning–regional,PCT,PBCtotheindividualHowwillSDSbeincorporatedinhospitaldischargeplanningforthoseneedinglong-termsupportWillSDSdrawfundsintothecommunityfromtheNHSWhataretheimplicationsfortheLAAStrokeservicesHowcanabetterdevelopedpathwaybeestablishedfromacutetreatmenttolongtermconditionmanagementwithinacommunitysettingSecondarycareconsultantsrecogniseagapindischargeplanningandareunawareofthenextstepsforapatientonleavinghospital.
Thisissuecouldbeledfromawell-beingperspectivetoenablepatientstoregain'citizenship'.
WhatarethegapsinservicesegpsychologicalservicesWhatistheextentofjointcommissioningofservicesandhowcanitbedevelopedPracticeBasedCommissioningHowwillPBClinkwiththeLSPandJointStrategicNeedsAssessmentIsthisavehicleforNHSfundstobespentonsocialcareSingleAssessmentProcessInitialoverviewassessmentscanbecarriedoutbyhealthorsocialcare.
Itisawiderangingassessmentdesignedtoaddressnotonlyimmediateneedbutotherareaswhereapersonmaybenefitfromhelpinbothhealthandsocialcarecovering:theperson'sperspective,senses,clinicalbackground,diseaseprevention,mentalhealth,personalcareandphysicalwellbeing,immediateenvironmentandresources,relationshipsandsafety.
LancashireismakinggoodprogressindevelopingaSAPandcandemonstrategoodpractice.
However,therearerisksthatthesystemmaynotbefullyutilisedatthefrontline,andthegoalof'tellingthestoryonce'notbeingmet.
DischargePlanningToexaminethepatientpathwayfromacuteorsecondarycarethroughtosupportintheirownhomefollowingdischargefromhospital.
1Appendix'B'AdultSocialCare&HealthOverview&ScrutinyCommittee-WorkPlan2008/2009ThisplansummarisestheworktobeundertakenbytheCommitteeduring2008/2009MeetingItemTypeofBusinessLeadKeyQuestionSeptember2008MeetingPatientsNeeds–ELHT/ELPCTEastLancashirePCTReviewimplementationToinformworkplanningGaryGrahamDavidPeatToreviewimplementationoftheMPNprogrammeandcustomersatisfactionsurveyfeedback.
ToinformthecommitteeofEastLancashirePCTsLocalDeliveryPlan2008/9November2008AnnualComplaintsandRepresentationsReportToinformworkplanningRichardJonesToexaminetheannualreportofcomplaintsandrepresentationsmadetothecountycouncilregardingAdultSocialCareServices.
StandingItemsEachmeetingReportoftheASC&HOSC'sHealthSteeringGroupMelOrmesherReportonliaisonwithdifferentNHSbodiesregardingserviceissues,publichealth/workplanningandconsultationwiththeOSC.
EachmeetingWellbeingConsiderimplicationsforwellbeingagendaineachreviewitemMembersWhataretheimplicationsforwellbeing2MeetingItemTypeofBusinessLeadKeyQuestionJointCommitteesOctober2008JointBlackpool,CumbriaandLancashireOSC–AmbulanceServiceReviewNWAmbulanceServicesReconfigurationofNWAScontrolroomsandservicedeliveryfollowing'TakingHealthcaretothePatient'policydocumentNameofTaskGroupCompletionDateforWorkofTaskGroupEquitableAccesstoPrimaryMedicalCareJune2008OralHealthTaskGroupestablishedtolookatimplicationsfororalhealthfollowingsubmissionstocommitteeonNHSDentistry(MembersCCTerryAldridge(chair),CCMilesParkinson,CCDorothyWestell,CCMikeCalvert,CCStephenSutcliffe,CllrBridgetHilton(RibbleValley),DistrictMemberAdultSocialCareandHealthOverviewandScrutinyCommitteeMeetingtobeheldon8July2008PartI-ItemNo.
12ElectoralDivisionaffected:NoneItemsforInformation(Appendix'A'refers)Contactforfurtherinformation:MelOrmesher(01772)536659,OfficeoftheChiefExecutiveExecutiveSummaryThisisoneofaseriesofregularreportsoninformationitemspresentedtosupporttheworkoftheCommittee.
TheitemsforJuly2008aresetoutatAppendix'A'.
RecommendationTheCommitteeisaskedtonotethereport.
BackgroundAtitsmeetinginAugust2006,theCommitteewasinformedthat,inordertosupporttheworkoftheCommittee,itwasproposedtopresentaregularreportonthecurrentissuesintheareaofAdultSocialCareandHealth.
Thereportwouldincludepolicyguides,briefingpapers,consultations,bestpracticeguidesandgovernmentguidance.
Accordingly,theitemslistedinAppendix'A'areforbackgroundreadingandgeneralinterest.
ThisenablesindividualCouncillorstoidentifyitemsofinteresttothem,andhavetheopportunitytoaccessandreadtheitemsattheirownconvenience.
WheredocumentsareessentialtotheCommittee'sconsiderationsatameeting,thesewillbecirculatedwiththeAgendapapers.
ThedocumentslistedintheAppendixcanbeaccessedelectronicallyfromtheappropriateorganisationwebsitesandlinksareprovidedforthispurpose.
WhilstCouncillorsareencouragedtousetheelectronicversionsoftheseitems,papercopiescanberequestedifnecessarythroughtheOfficeoftheChiefExecutive(Tel01772530596),whichcouldthenbeposted.
--2ConsultationsN/AAdviceN/AAlternativeoptionstobeconsideredN/AImplications:e.
g.
Financial,Legal,Personnel,HumanRights,CrimeandDisorderorOtherThisitemhasthefollowingimplications:N/ALocalGovernment(AccesstoInformation)Act1985ListofBackgroundPapersPaperDateContact/Directorate/ExtReasonforinclusioninPartII,ifappropriateN/A1Appendix'A'AdultSocialCareandHealthOverviewandScrutinyCommitteeTuesday8July2008AgendaItem12:ItemsforInformation1TacklingObesities:FutureChoices-theForesightReportTheForesightReport'TacklingObesities:FutureChoices–ProjectReport'waspublishedin2007.
Inrelationtothereport,theIDeApresentssomeoftheimplicationsforlocalgovernmentonhowtheycancontributetoreducinglevelsofobesity.
AbriefingandfulldocumentareavailablethroughtheImprovementandDevelopmentAgency(IDeA)at:http://www.
idea.
gov.
uk/idk/core/page.
dopageId=82679262Men'sHealthTheIDeAwebsitehasaspecificsectionrelatingtomen'shealth.
Itlooksatphysiological,psychologicalandgenderissuesanddifferentprojectsthathavebeensetuptoaddressmen'shealthandinequalitiesthatpresentlyseemenatahealthdisadvantagewhencomparedtowomen.
Thisinformationcanbefoundbyfollowingthelink:http://www.
idea.
gov.
uk/idk/core/page.
dopageId=58900633UserInvolvementinPublicServicesThePublicAdministrationSelectCommitteehaspublishedtheUserInvolvementinPublicServicesreportaspartofitsinquiryinto'PublicServices:PuttingPeopleFirst'.
Thisreportlooksatwhatcouldbeachievedbypublicservicesengagingpeopledirectlyinservicedesignandprovision.
AbriefingbytheLGiUandthefullselectcommitteedocumentcanbefoundat:http://www.
lgiu.
gov.
uk/briefing-detail.
jsp&id=1847&md=0§ion=briefing4LocalInvolvementNetworks(LINks)GuidanceTheNHSCentreforInvolvementhasbegundevelopingaseriesofguidancedocumentsforestablishing,developingandgettinginvolvedinLocalInvolvementNetworks.
ThewebsitealsoprovidesaccesstotheLINksRegulations2008,andarangeofotherbriefings:http://www.
nhscentreforinvolvement.
nhs.
uk/index.
cfmContent=19625Seeme,notjustthedementia:understandingpeople'sexperienceoflivinginacarehomeTheLGiUprovidesabriefingontheCommissionforSocialCareInspectionreport,alongwithalinktothefulldocument.
CSCIassessedthecareandwellbeingofasampleofcareresidentswithmoderatetoseveredementia,inordertoseehowhomespromoteddignity,respectandpersonalisation.
FollowingregistrationwiththeLGiU,thebriefinganddocumentcanbeaccessedthroughthelink:http://www.
lgiu.
gov.
uk/briefing-detail.
jspid=1867&md=0§ion=briefing6EastLancashireteachingPrimaryCareTrust–CarersCharterELtPCThaslaunchedits5stepCarersCharteraimedatpromotingcarersandtheirneeds.
ThefullchartercanbeobtainedfromthecommunicationsteamatthePCTandwillsoonbeavailableontheirwebsiteat:http://www.
eastlancspct.
nhs.
uk/