STOCKPORT PRIMARY CARE TRUST
MINUTES OF THE PROFESSIONAL BOARD MEETING
HELD AT REGENT HOUSE, HEATON LANE, STOCKPORT
THURSDAY 29TH NOVEMBER 2007
Mr M Greenwood Chair
Ms J Crombleholme Non Executive Member
Mr A Durrant Non Executive Member
Mr P Foster Non Executive Member
Mr G Hayward Non Executive Member
Dr D Dawson Professional Executive Committee Chair
Dr R Gill Stockport Managed Care Commission
Mrs S Parker Clinical Governance Lead
Mr R Popplewell Chief Executive
Mrs A Tonge Deputy Chief Executive and Director of Finance and Estates
Dr S J Watkins Director of Public Health
Cllr M Clay SMBC Executive Lead Councillor – Adults and Communities
Mrs G Frame Director of Provider Services
Mr M Lappin Stockport Patient & Public Involvement Forum
Ms J Lord Director of Human Resources
Mrs C Watson Acting Director of Primary Care & Partnerships
Mr D Hill Non Executive Member
Mrs R Mirza Non Executive Member
210/07 DECLARATION OF INTERESTS
There were no declarations of interest.
211/07 MINUTES OF THE LAST MEETING HELD ON 25 OCTOBER 2007
194/07 There was a correction made regarding a report to Board on merging
commissioning activities which will come to January Board.
206/07 The next meeting recorded in the minutes was amended to 29th November.
212/07 ACTIONS ARISING FROM THE MINUTES
100704 R Popplewell reported that the Pay for Quality paper will be delayed until
the next Board.
213/07 CHAIRS REPORT
M Greenwood regretted to report that Steve Smith (Director of Planning and
Business Development) at Stockport Foundation Trust had suddenly passed away.
A Greater Manchester Health Commission event was currently underway to look at
a vision for city governance. M Clay reported that she had attended during the
morning and it had been a good meeting looking at areas where commissioners
can add value. Areas identified were the need for greater communication and the
important role in commissioning with other partnerships.
214/07 CHIEF EXECUTIVES REPORT
R Popplewell referred to the briefing contained within the papers on Making It
Better and the key issues identified by the Joint Committee of PCTs. P Foster
commented that it was very pleasing to see a number of the recommendations
from Making It Better being positively put into effect. Board noted the paper.
Boards attention was drawn to the tabled paper that had been distributed via email
to members on the Picture Archiving and Communications System (PACS).
Because the sum involved was above the Chief Executive’s delegated limit the
PCT Board was asked to approve the payment of the invoice from Stockport
Foundation Trust in the sum of £790,000 for 2007/08 in respect of agreed South
East sector funding relating to PACS costs. The Board ratified the payment.
R Popplewell informed the Board that the Healthcare Commission will be
inspecting NHS trusts to check on the actions they are taking to meet their legal
duty to promote race equality for black and minority ethnic (BME) staff and
patients. An audit published by the Commission has shown Stockport PCT to have
poor performance in this area and it is possible that the PCT will be included in the
list of Trusts to be visited.
S Watkins reported that the PCT has reviewed its performance against compliance
with legal duties. Although there is much good practice there are five areas of non
1. The PCT has not adequately published its strategy – Discussions underway to
deliver appropriate web page.
2. The PCT does not currently carry out impact assessment – This has been held
up by training needs but will be fully in place by 1st April 2008.
3. Some elements of our action plan are not being adequately performed – A new
member of staff is to be appointed to coordinate this.
4. The Gender Equality scheme is a little this – this will be reviewed.
5. The PCTs Gender, Age and Disability Equality scheme pay less attention than
they should to various service users i.e. premises for disability, age discrimination
in services and men’s health for gender. These will be reviewed.
The Board noted the position and that a more formal action report will come to
Board in the New Year.
215/07 REPORT OF THE PROFESSIONAL EXECUTIVE COMMITTEE CHAIR
D Dawson reported that he had attended the national PEC Chairs meeting. There
had been a presentation providing guidance to PEC chairs on the role of PEC. This
included ensuring patient focus, to deal with health inequalities, and clinical and
organisational scrutiny of plans to support the Board.
216/07 SMOKING – PUBLIC HEALTH REPORT
S Watkins presented a paper to Board on trends in smoking prevalence and the
outline tobacco control and smoking cessation strategy.
I in 5 adults in Stockport currently smoke. Targeted work has resulted in rates of
access being higher however quit rates have gone down.
There was a discussion about smoking amongst young people. The Board asked
that the Public Health Partnership Board consider ways of addressing this. One
member suggested that although young people are not fearful of dying it may be
more effective to point out to them some of the physical disabilities that can occur
from long term smoking. Councillor M Clay added that she is convinced that
dealing with total lifestyle is the answer rather than addressing one unhealthy
practice at a time.
D Dawson raised an issue about the data collected on prevalence and the fact that
this does not pick up on people who have given up smoking themselves.
Board noted the report and the work that would be taken up by the Public Health
217/07 THE FORESIGHT REPORT
S Watkins presented a summary on the Government Office of Science’s Foresight
Report on Obesity.
A number of proposals for improvement to the PCTs Obesity Strategy were
outlined in the paper to ensure that it is updated to deal with the issues raised in
the report. The Board agreed that although the PCT is doing reasonably well, a
step change in attitudes is required and the proposals for improvement to the
strategy should be referred to the Public Health Partnership Board for
The Board supported the development of a weight management programme in
Primary Care and the reinstatement of a health promotion adviser for workplaces
for consideration within the LDP. They also agreed that Stockport PCT
Management Team should consider the proposal for becoming an exemplar
employer for adopting healthy catering guidelines.
C Watson added that the PCT/SMC had allocated £150,000 towards childhood
obesity non-recurrently this year.
218/07 MENTAL HEALTH SERVICES – PROPOSAL FROM PENNINE CARE
R Popplewell presented a paper setting out proposals and a case for change for
modernising Stockport Acute mental health services to develop a fully functioning
Crisis Resolution Home Treatment Team through utilisation of the resources freed
by a closure of an inpatient ward and the development of improved adolescent
It is proposed to complete the development of the crisis resolution/home treatment
(CRHT) service with sufficient capacity to deliver the activity and service model
recommended for the population of Stockport.. This can be achieved by reducing
the adult in-patient beds and re-investing resources into developing the CRHT
team. It is proposed to close Warren Ward. Pennine Care will retain both clinical
and financial responsibility for any patient requiring an admission so that the PCT
will not be subject to the ‘risk’ of insufficient inpatient beds to admit all necessary
A Durrant commented on the lack of detail of the numbers of patients affected by
the change within the paper. Richard Spearing (Director of South Division, Pennine
Care) said that the Home Treatment service would be managing around 50
patients and confirmed that Pennine Care would underwrite the requirement
around any inpatient admissions.
G Hayward said that it would have been useful to know the actual
need/requirement in Stockport rather than just national averages. R Spearing said
that the figures were based on national calculations then weighted for Stockport.
There was a discussion about the level and process for reinvestment of the finance
released by the ward closure for the new service.
On adolescent inpatient inpatient services Richard Spearing described the
intention to develop an interim service initially in Bury from April 2008 and then in
Oldham from April 2009.
M Lappin informed Board that he had queried at the Local Overview and Scrutiny
Committee whether a formal consultation was required on the closure of Warren
Ward. The Patients Forum were in the process of checking this.
It was agreed that further details of the service model will be presented to SMCC
for their comment and approval.
On the basis that the service model was acceptable the Board agreed to the
closure of Warren ward and supported the reinvestment of the resources released
to the CRHT to deal with the demand from the client group with any further
resources released being considered within the 2008/09 Local Delivery Plans
process to improve Mental health services in other areas.
219/07 JOINT STRATEGIC NEEDS ASSESSMENT
Jane Rossini (Deputy Director of Public Health, Stockport PCT) and Stuart Cowley
(Head of Modernisation, Stockport Council) presented key messages from the
Joint Strategic Needs Assessment (JSNA).
There has been a lot of work undertaken proactively between the PCT and the
Council as the lead commissioners of whole health system. As commissioners of
local services a lot of information is gathered about people and there is a challenge
to make sense of this large range of data.
The task has included a high level analysis of trends, and identification of
population needs. There has been broad analysis to feed into dialogue with
commissioners of services, to inform future models of provision.
J Rossini picked out some highlights from the findings:
Aging population - There are an extra 2,700 coming through at age 65 and
Trends in birth rate – higher than expected
Fertility by deprivation – there are larger families in deprived areas. G
Hayward asked home many of these were single parent families. J Rossini
agreed to explore this.
Changing ethnicity – there is a large cohort coming through
DNA rates – Indian and Bangladeshi in particular in Podiatry
Life expectancy and health life expectancy – need to be thinking about
people still of working age and engaging them. G Hayward asked if those
undertaking manual labour in the more deprived areas would contribute to
this. J Rossini considered that this may be the case and that she would
explore the opportunity of working with employers.
S Cowley reported on how engagement of the JSNA is being built up.
Presentations are taking place with commissioners, data providers, major service
providers and interest groups and there is a local event being held on 10
December covering several topic areas.
There will be a follow up with a wider group as part of a health and wellbeing
session at Stockport Partnership Board in late January. This is the start of a
process to embed new ways of ensuring evidence of need in the community
effectively influences the services the PCT/Council commissions.
The JSNA provides an opportunity to join up and better deploy data collection
processes, pool data to improve the quality and effective targeting of the
commissioning of resources to support health and wellbeing in Stockport.
Following a query Board were informed that discussions are taking place about
how this fits with the existing Director of Public Health report process.
Board supported the JSNA and process of engagement and thanked Jane and
Stuart for the work undertaken.
220/07 PRIMARY CARE ACCESS PLAN
C Watson presented the PCTs action plan to improve access to General Practice,
a national requirement in response to the patient survey results as part of the
2006/07 Access Directed Enhanced service (DES).
In the 2007 patient survey 87% of patients reported that they were satisfied with
GP practice opening times. Of the other 13%, 51% were dissatisfied with no
Saturday morning surgery and 24% dissatisfied with no evening surgeries.
In line with Government direction, the PCT has agreed to address this by
supporting practices to pilot improving access through routine appointments on
Saturday mornings for 4 months. There have been seven proposals received so
Members discussed whether this pilot is worthwhile. However it was explained that
this is something that all PCTs have been asked to do. R Gill suggested that this
service be focussed on Long Term Conditions and those with established, complex
S Parker emphasised the need for ongoing audit throughout the pilot to look at how
and who it will be used for.
Board noted the progress and developments being undertaken to improve access
to general practice.
221/07 OLDER PEOPLE UPDATE
M Greenwood introduced Maggie Kufeldt, the joint commissioning lead for older
people for Stockport Council and the PCT.
M Kufeldt presented an update to PCT Board on progress made to improve and
develop Older Peoples Non Acute Services. A further report will come to the next
The PCT and Stockport Council are commissioning a new model of non acute
services for older people to support the vision of more choice through alternatives
to bed based services.
A collaborative application from the PCT, Stockport FT and Stockport Council was
put in to be the Partnership Development Lead (PDL) to develop the new service.
A timetable was intimated with a date of 31st March 2008 as the first target date for
the first phase of the new service to be in place and the possible date of the first
A number of issues have merged that have delayed the plan included concerns
about delivering the first phase within the required timescales, particularly the ward
closure and staff issues.
G Frame commented that the PCT’s Provider Services have been undertaking a lot
of work and are keen to progress further.
M Greenwood said that there should be a focus on closing inadequate services
and releasing the resource. M Kufeldt said that a detailed mobilisation plan is
expected from the PDL in the next 10 days. If this does not come in with
reasonable approaches a contingency plan is being developed and may have be
222/07 OPERATIONAL PERFORMANCE REPORTS
A Tonge updated the Board on the financial position at month 7. The PCT is
reporting an under spending of £2,557,000 at month 7 with a forecast under spend
of £1,757,000 in line with plan.
A combination of slippage against LDP investments and improved performance
has resulted in savings of around £3.9m. This is a good news story as the PCT has
performed well on the efficiency planned and these slippage monies are being
used to fund a number of bids. These bids have gone through a prioritisation
process with the SMCC and the PCT Management Team and include areas such
as mental health, IT, alcohol etc. P Foster thanked Management Team for getting
these bids progressed.
On the capital plan a request has been put in to convert revenue to capital. If
approved this would allow the PCT to acquire some land for the next phase of
schemes. A mini business case will come to Board.
A Tonge presented the 18 week report of performance against trajectory. At
September 2007 66% of non admitted patients received care within18 weeks of
referral and 54 % of admitted patients. This is less than the national average.
However there is a lot of work going on in service redesign. R Gill added that
system redesign is just as important as increasing capacity. A Tonge said that a
report will come every month with more structures in terms of pathway redesign.
Board noted the Operational Performance report and approved the allocation of
funds to specific schemes within it.
223/07 PROVIDER PERFORMANCE REPORT
G Frame presented the Provider Services report. There is a current under spend of
Board noted the report.
224/07 CONTINUING CARE CHANGES
M Kufedlt presented a paper on the requirements of the National Service
Framework for NHS Continuing Care and NHS Funded Nursing Care and the
progress that has been made towards fully implementing the framework in the
Stockport Social and Health Care Economy. The report identified implications for
organisations and individuals working in Stockport and makes recommendations
about how organisational ownership of the new policy and practitioner
understanding of the roles and responsibilities.
Under the system PCTs will follow a common approach and the checklist will now
be based on a persons needs and not whether services are available.
An external consultant was commissioned to undertake a ‘state of readiness’
assessment of Stockport PCTs current position. Locally there will be implications
on workload due to the required change in operational policy and there are a
number of training issues.
Financial impact could be up to £1.7m for the PCT due to lowered threshold for
eligibility. J Crombleholme added that there is a direct payment issue – people who
used to pay for their own packages of care are now getting a package of care paid
for but is not to the level that they originally had.
Board noted the progress report and implications of the new policy.
225/07 STOCKPORT MANAGED CARE REPORT
R Gill provided a report from SMCC on progress in the delivery of the 2007-08
Accountability Agreement Quarter 2.
R Gill reported that SMC had held an away day looking at the way forward for
general practice. M Farrar had attended and been strongly supportive of all that
SMC want to achieve.
Board noted the progress.
226/07 COMPLAINTS REPORT – QUARTER 2
R Popplewell presented the Quarter Complaints report. Board noted the report.
227/07 BUSINESS PLAN – QUARTER 2
T Ryley presented the mid year position on delivery of the business plan. The good
progress on the large number of initiatives was noted.
The main concern is around the ambulance service targets and Chlamydia
The report was approved .
228/07 SEVEN PRINCIPLES OF PUBLIC LIFE
The seven principles of public life were noted by Board. They were also informed
that these had been distributed to staff.
229/07 AUDIT COMMITTEE MINUTES
The audit committee minutes of 18th September were noted.
230/07 UNCONFIRMED PEC MINUTES
The unconfirmed PEC minutes of 8th November were noted.
231/07 ANY OTHER BUSINESS
There were no items of any other business.
232/07 DATE OF NEXT MEETING
Thursday 20th December 2007.