(a)   there were two specialist liaison nurses and a learning disability link who provided specialist safeguarding advice day and night;

(b)   it was the lead/link nurse’s role to up-skill colleagues and it was felt there were enough nurses to carry out this function;

(c)    there was a well publicised whistle-blowing procedure for staff;

(d)   the trust were developing their medium term financial plan which would require further input from the panel at a later date;

(e)   the savings target for the trust was £31.2m which equated to non-pay savings of £14m and pay savings of £17m equal to around 7% of the total pay budget;

(f)     there had been £27m of savings identified to date, these would be achieved through a reduction of 130 beds, two theatres, less outpatients, better procurement, a lower pay bill and fewer staff.

(g)   the £12m received last year was financial support from the South West Strategic Health Authority;

(h)   there would be changes to the model for provision of care as a result of the efficiency savings plan. The reduction in the number of beds in the hospital was based on patients being cared for in the community;

(i)     the number of readmissions was closely monitored and there were financial penalties for the Hospital if readmissions occurred soon after discharge. Discharge was not considered by clinical staff until the patient was fully fit and work was being carried out to improve the discharge process;

(j)     beds could be made available at short notice and the Trust has a good understanding of trends to plan for the availability of beds. Bed closures were linked to pathways of care and there was flexibility in the system to allow beds to open during the winter;

(k)    the threshold for discharge would not be lowered, patients would only be discharged when medically fit;

(l)     areas of the hospital are often ‘mothballed’ but the trust was able to activate beds and wards quickly;

(m)in order to tackle staff dissatisfaction the trust was focusing on the ward sisters’ and charge nurses’ role as leaders. The trust recognised that staff morale was integral to the success of the hospital and was working hard to address a difficult task however this could not be addressed directly from board level but providing support to ward sisters and charge nurses;

(n)   the requirement to make efficiency savings would continue year on year but would not be to the same scale as reported in the Annual Plan 2011 - 12.

(1)   to write to Plymouth Hospital NHS Trust requesting details of the status of the financial support provided by the South West Strategic Health Authority delegated to the lead officer, in consultation with the  ...  view the full minutes text for item 9.

(a)   a number of services would be reviewed under budget delivery plans, these included domiciliary care services, supported living, care management services, day care, enabling and floating support and residential care for people under 65 years old. There would also be workforce re-modelling supported by the introduction of care management software;

(b)   a transformation of services was required as the current system was under pressure with escalating costs and no evidence of improvement in satisfaction for people. The current system was unclear, unfair, unsustainable and  provided insufficient value for money;

(c)    transformation of service would mean that more people would have control over their care through the use of personalised budgets and access to high quality information and advice;

(d)   there would be a greater focus on early intervention and prevention and increased access to reablement;

(e)   there would be a focus on quality assurance and outcomes with personal budgets, direct payment and self directed support becoming mainstream.

(f)     there was one Southern Cross managed residential home in the City, care had not been compromised and there was a review team monitoring the levels of care at the home;

(g)   there was a Safeguarding Adults Board in operation though the current configuration was under review. Where there were specific concerns review teams are able to enter homes. There had been cases where unannounced inspections had taken place;

(h)   personal budgets allowed people to make real choices about their own care. The council offered a limited menu of institutional care. Personal budgets would allow people experiencing health difficulties to realise the opportunities that many people can take for granted;

(i)     the Dementia Programme Board membership would be reviewed over the next month.

(a)   main components of the Bill were designed to put patients and the public first, improve health outcomes, increase local democratic legitimacy and the effective commissioning and regulation of health care providers;

(b)   clinical consortia would commission services for local people with the NHS commissioning board taking control of primary and specialist care commisioning;

(c)    statutory Health and Wellbeing Boards would be required in every upper tier local authority. The Health and Wellbeing Board would bring together commissioners and providers along with the local authority to develop a Joint Health and Wellbeing Strategy and oversee the development of the Joint Strategic Needs Assessment on which the commissioning plans would be based;

(d)   scrutiny processes would remain with the local authority to discharge as required locally;

(e)   LINks would be developed into Local Healthwatch and the Plymouth LINk had requested to be a pathfinder in this area;

(f)     implementation and transition would be supported by the Quality Innovation, Productivity and Prevention programme, transforming community services and by establishing systems and structures;

(g)   the transition would take place over four years with the new system being tested by early implementers and path finders;

(h)   commissioners in Plymouth had created a Clinical Commissioning Executive as a sub committee of the NHS Plymouth Primary Care Trust Board and would develop as the commissioning consortium for the city.