Personal and Health Services Scrutiny Panel

Cardio Vascular Disease (CVD)

More than 110,000 people in England die from heart disease every year – one in every four men and one in every six women die from the disease.

In Tameside, heart disease is one the main causes of premature death. The Tameside LAA performance measure for mortality from CVD amongst under 75s did not meet target in 2009-10 (NIS 121, quarter 3 data).

In March 2009, Tameside and Glossop became one of 16 national pilot areas for the Integrated Care Pilot which explores ways of delivering care closer to the patient’s home. The programme in Tameside focuses on preventing and reducing CVD rates.

In April 2009, the National Support Team for Health Inequalities recommended that NHS Tameside and Glossop strengthened the delivery of the CVD programme.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Adult Services

Scrutiny Panel

Stroke Care

In 2007 the Department of Health published a 10 year National Stroke Strategy which set out a framework of 20 quality markers for raising the quality of stroke prevention, treatment, care and support services over the next decade.

Nationally stroke is the third most common cause of death and the single largest cause of adult disability.

There are over 900,000 stroke survivors in England and 300,000 people live with moderate to severe disability as a result.

In the North West the incidence, prevalence and mortality of stroke is amongst the highest in the country.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Adult Services

Scrutiny Panel

Chronic Obstructive Pulmonary Disease (COPD)

Approximately one million people in the UK have COPD and at least 25,000 people die each year from the end stages of the disease. Many of these people have several years of ill health and poor quality of life before they die, but chronic ill health and death is preventable in most cases.

COPD is usually caused by smoking. The Tameside LAA performance measure for four week smoking quitters (NIS 123) is expected to meet target for 2009-10. However, smoking rates in Tameside are still higher than the North West and England averages.

In April 2009, the National Support Team for Health Inequalities highlighted that smoking was the biggest cause of health inequalities in the borough.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Adult Services

Scrutiny Panel

Cancer

The likelihood of developing cancer increases with age and the number of people requiring treatment and living with cancer is expected to rise for the next ten years. However, approximately half of deaths from cancer are preventable with lifestyle improvements, screening, early intervention and effective treatments.

Death rates for all cancers, as a whole, are higher in Tameside and Glossop than the average for the North West and England.

Mortality rates from lung, colorectal and prostate cancer in Tameside are all above the England average. There is also a variation in death rates from lung cancer between wards in Tameside and Glossop and screening uptake varies between GP practices.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Adult Services

Scrutiny Panel

Alcohol Misuse

Alcohol misuse is widespread in England. 33% of men and 16% of women drink alcohol at levels that are hazardous to their health.

The North West Public Health Observatory estimates that, of 352 local authority areas in England, Tameside is the 312 th worst for binge drinking and 347 th worst for harmful drinking. The PCT estimate that, in 2008-9, over 30,000 men and over 13,000 women had an alcohol use disorder.

Alcohol misuse can cause short and long term physical, psychological and social problems.

In February 2010 AGMA Executive agreed to advocate nationally and locally a minimum unit price for alcohol of 50p; aimed at reducing alcohol consumption and harmful drinking.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Scrutiny Panel

Dementia/Mental Health

It is estimated that there are over 570,000 people in England living with dementia. This figure is likely to double over the next 30 years, in the absence of any medical breakthrough in treatment. Dementia has a profound effect on family carers and costs the UK economy £17 billion a year.

Positive input from health and social care services and from the third sector and carers of people with dementia can make a significant difference in improving the quality of life of people with dementia.

A National Dementia Strategy was launched in February 2009 to improve awareness of dementia, earlier diagnosis and intervention, and a higher quality of care.

Tameside is an early adopter for National Dementia strategy.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Scrutiny Panel

GP Services

NHS Tameside and Glossop (PCT) contracts 39 practices to provide medical care from 40 premises.

GPs have to provide this care during ‘core hours’ from 8am to 6.30pm. Outside core hours the PCT contracts ‘GOtoDOC’ to provide urgent primary care. The current Out of Hours service contract comes to an end in 2010.

Although all GP practices provide a wide range of family health services, many also deliver additional services such as minor surgery.

Based on their own experiences of care, and those of members of the public, it has been suggested that GP services in Tameside be considered to ascertain whether there are any concerns that can be addressed in relation to the quality of services, health prevention, health inequalities or other issues.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Scrutiny Panel

Tameside Hospital NHS Foundation Trust

Following the March 2011 review of Acute Services and Planned Care Quality Commission Review in March 2011 and Monitor Authorisation Breach letter March 2011 the Panel will continue to monitor the foundation Trust on a regular basis.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

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Tameside Hospital NHS Foundation Trust - Non Executive Directors

The Scrutiny Panel will continue to invite the Non Executive Directors of the Trust to a meeting of the Panel in order to understand their role in holding the Trust to account and their statutory powers and duties; particularly in relation to improving hospital performance and the quality of services.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

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NHS Tameside and Glossop (PCT)

Tameside is a “Spearhead Community”. The area has high levels of deprivation, relatively low life expectancy and high mortality rates for major causes of death, such as heart disease and cancer.

The Scrutiny Panel will continue to monitor the PCT’s progress in meeting local challenges, in particular: -
• meeting increasing demand for health services with less funding;
• improving commissioning/ decommissioning; and meeting the requirements of ‘World Class Commissioning’;
• supporting Tameside Hospital NHS Foundation Trust to improve services; and
• the outcome of NHS North West’s assessment of local commissioning in Tameside.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

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Regulatory Framework – Meeting with Monitor, CQC and NHS North West

The Care Quality Commission (CQC) is the independent regulator of health and adult social care services and was established in 2009.

Monitor is the independent regulator of NHS Foundation Trusts and was established in 2004. Monitor ensures Foundation Trusts are well governed, and operate effectively, efficiently and economically.

NHS North West is the Strategic Health Authority (SHA) for the North West. The SHA provides strategic leadership for the region’s healthcare and has overall responsibility for the performance of 24 PCTs, 31 acute trusts, 8 mental health trusts and the North West Ambulance Service.

Meeting with these organisations would enable the Scrutiny Panel to further develop their understanding of their respective roles and responsibilities, and how they work together as regulators to ensure the safety and quality of NHS services.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Tameside LINk (Local Involvement Network)

LINks were established with the Local Government and Public Involvement in Health Act 2007, which abolished Patient and Public Involvement Forums as the voice of local people on matters of health care.

LINKs are designed to help local people and voluntary and community groups to influence the design and commissioning of local health and social care services.

Tameside Third Sector Coalition (T3SC) is the host organisation for the Tameside LINk.
It is important that the Scrutiny Panel and the LINk work together effectively to support each other in their similar roles and avoid duplication.

The Scrutiny Panel will receive the LINk Annual Report and outcome of their reviews; and meet with the TMBC Contract Manager for the LINk.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Housing Services

In January 2010, Tameside Council launched a new Housing Strategy (2010-2016) which was based on extensive research and consultation during 2008-09 on :

• the condition of housing stock in the borough; and
• future housing market needs and demands.

In 2010, the council will publish a new Affordable Housing Policy and in autumn the Audit Commission will undertake a housing inspection.

In January 2009 the Scrutiny Panel considered the impact of the recession on social housing and homelessness. Given that the economy is now moving into growth, the Council’s Strategic Housing Service now expects the following issues to arise:

• increased pressure on social housing; and
• increased demand for households to be re-housed.

In turn, this may affect the housing allocations strategy, which has been a long standing concern for Members.

Further to the January 2009 meeting; issues have since arisen around the quantity and quality of housing and meeting peoples’ housing needs; which may be of concern to Members.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Clinical Assessment and Treatment (CATs) Service

Care UK has been contracted by the 10 local PCTs in Greater Manchester and the Department of Health to provide a mobile Clinical Assessment & Treatment Service (CATS) in Greater Manchester.

The service is designed to be a ‘one-stop shop’. Patients are referred by their GP to the CATs service, instead of a local hospital. They are seen by a consultant, have any tests required, and receive treatment.

The CATs service is mobile, moving on a rotational basis to a number of sites in Greater Manchester. The service treats patients in community settings in order to help reduce hospital waiting times.

The Scrutiny Panel have a role in monitoring local health services, including the impact of CATs particularly regarding: -

• the rate of referrals and the impact on Tameside General Hospital;
• patient experience and feedback; and
• waiting times for treatment.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

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Health Partnership

The Health Partnership provides a framework for action to improve health and address health inequalities in Tameside.

The new Health Improvement and Health Inequalities Strategy 2009-19, “Our Life in Tameside”, will be published in 2010 and sets out six key objectives for improvement. The outcomes will be monitored and measured by a range of performance indicators including Local Area Agreement targets.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

Personal and Community Services

Tameside Area Agreement Targets

The Panel will continue to have regard towards the Tameside Area agreement (TAA) as it did to the previous Local Area Agreement. 

i. scrutinise progress towards achieving TAA targets;
ii. request information from partner organisations signed up to particular TAA targets;
iii. expect partner organisations to consider and respond to scrutiny recommendations concerning the targets they are signed up to.

The Scrutiny Panel will receive performance monitoring information on TAA targets relating to this Scrutiny Panel on a quarterly basis.

This performance monitoring exercise supports the Council and Sustainable Community Strategy priorities relating to ‘Supportive Tameside’, ‘Healthy Tameside’, ‘Safe Tameside, and ‘Attractive Tameside’.

Tameside Strategic Partnership

Care Quality Commission

The Care Quality Commission (CQC) replaced the Healthcare Commission as the independent regulator of health and adult social care services in 2009.

Previously, the Scrutiny Panel submitted annual third party commentaries to the Healthcare Commission (the Annual Health Check) evidencing how the Panel believed local NHS Trusts had performed against National Standards.

The CQC are seeking a more flexible working relationship with scrutiny. Scrutiny Panels can submit evidence about the quality and safety of all health and adult social care services at any time, in order to inform the regulator’s on-going monitoring and assessment processes.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

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Quality Accounts

In 2010 the Department of Health will introduce the requirement for all NHS healthcare providers to produce Quality Accounts. They will describe the quality of services NHS providers delivered in the previous year and set out the main priorities for improvement in quality of services for the forthcoming year.

The requirement to produce Quality Accounts will be extended to primary care in 2011.

Scrutiny Panels will have the opportunity to comment on the content and accuracy of the Quality Accounts provided by all local NHS Trusts.

This supports the aims of the Sustainable Community Strategy and Local Area Agreement ‘Supportive Tameside’ and ‘Healthy Tameside’.

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