Agenda and minutes

[Chair to request notification of Apologies]

There were no apologies for absence

[any declarations of interest from Panel members]

Cllr Jaspreet Jaspal declared a pecuniary and non-pecuniary interest in agenda item 4 as she was employed as a Optometrist.

[To approve the minutes of the previous meeting as a correct record.]

Resolved: That the minutes of the meeting held on 21 March 2023 be approved as a correct record.

[Presentation from the Integrated Care Board]

The Chair informed the Panel that Councillor Jaspreet Jaspal had left the room due to a pecuniary interest.

The Managing Director Wolverhampton (ICB) informed the Panel that they commissioned audiology in two ways; hearing aid fitting and hearing aid assessments were done through any qualified provider (AQP) contract; the main provider of the service in Wolverhampton for over 55’s was Specsavers. This service was covered by the National Health Service financially so patients would not have to pay.  For patients with hearing loss or complex ear issues under the age of 55, the service was commissioned by the Royal Wolverhampton Trust at West Park Hospital. The Managing Director Wolverhampton (ICB) informed the Panel that some patients would have a build up of ear wax which could contribute to hearing loss and also delay the inspection and installation of hearing aids. He said two principal methods were used to remove ear wax: ear irrigation and micro-suction. Previously the service was carried out almost exclusively by General Practitioners, utilising ear syringing methods; however, NICE guidance that was issued in 2018 recommended this practice no longer be used. Ear wax removal services now varied across General Practices in regard to service levels provided to patients. In Wolverhampton, 9 Practices offered the service in relation to removing ear wax to enable the provision of hearing aids. 21 General Practitioners provided the service through Penn Fields, via micro-suction, which had increased the uptake in ear wax removal since the service began in October 2020. He recognised that ear wax removal service provision varied across the Black Country and he informed the Panel the Integrated Care Board were looking to implement a more consistent approach across services.

A Panel member enquired about the listed hearing aid warranty period, which lasted 3 years. He wanted to know how a patient went about replacing their hearing aids after the warranty. He also wanted to know how many, if any others, providers for hearing services were there, aside from Royal Wolverhampton Trust and Specsavers.  He also asked if they had the data showing how many people in Wolverhampton had a hearing aid.

The Service Manager for Audiology at the Royal Wolverhampton Trust stated that after 3 years, if a patient came with a faulty hearing aid, they would be re-assessed and provided with a new hearing aid. The Service Manager for Audiology at the Royal Wolverhampton Trust replied that there was around 6 providers for AQP, but it was the decision of the General Practitioners where they designated patients to. She reported issues in service pathways, with patients being unnecessarily sent to the RWT, rather than an AQP provider, which then required a discharge back to the GP to then be re-referred.

The Managing Director (ICB) told the Panel they did not have figures on how many people in the City had a hearing aid.

The Councillor replied informing the ICB team that National Statistics were available, so he could not understand why localised data was not available.

The  ...  view the full minutes text for item 4.

[Presentation from the Integrated Care Board]

The Managing Director Wolverhampton (ICB) informed the Panel the Integrated Care Board (ICB) had contacted all Practices and Patient Participation Group (PPG) Chairs to find out what their position was in terms of PPG activity and progress getting operational again post-covid. There were a total of 37 practices, 30 reported back that their PPG had met at least once in the previous 6 months, where as the other 7 had not but had plans to re-establish their PPGs. The Managing Director Wolverhampton (ICB) informed the Panel that to support the full operational re-establishment of PPGs, they had delivered training to Practice Managers, as well as the Chairs of PPGs. They had also launched a webpage within their web domain with supporting information about PPGs which Practice Managers and PPG Chairs could access. He said the ICB was supportive and encouraging of the function of PPGs.

The Vice-Chair stated that 20 percent of the surgeries were not fulfilling their contract because their PPGs were not active and not meeting. He wanted to know what penalties could be applied to practices which were not ensuring their PPGs were active and meeting, he said he believed a meeting every 6 months was not enough and felt quarterly meetings would be appropriate to the needs of a PPG.

The Managing Director Wolverhampton (ICB) explained to the Panel that the contracts did not have stipulations wherein penalties were required. He said he felt the information previously given showed practices were moving towards re-stablishing functioning PPGs.

The Vice-Chair thanked the Managing Director Wolverhampton (ICB) for explaining the contractual situation but stated that he did not understand the purpose of having contractual obligations if the practices were not going to meet them, he wanted to know how accountability could be kept if there was not any system in place to keep the practices in check in delivering PPGs.

The Managing Director Wolverhampton (ICB) answered that all active PPGs were meeting quarterly or bi-monthly.

A Councillor debated the Vice-Chair’s position, stating he felt it was not possible for the Practices to get the volunteers for a PPG if members of the public did not want to engage.

The Manager of Healthwatch Wolverhampton replied to the Councillor that all evidence Healthwatch had gathered countered his claims, as it showed members of the public were invested in PPGs and that barriers to participation were the issue, with feedback participants complaining that PPGs were not being run properly. She said practices needed to do more to inform and encourage the public to join and to ensure that when members of the public did apply to join, that they were being responded to. She said a website was not enough, she said posters in the surgery, as well as using the automated texting service could be ways forwards to addressing some of this.

A Councillor discussed the voluntary nature of the PPGs, explaining that those attending and running it were members of the public. She stated that the PPG for her local  ...  view the full minutes text for item 5.

[To consider the Wolverhampton Joint Local Health and Wellbeing Strategy 2023-2028]. 

The Public Health Partnership and Governance Lead gave a presentation on the Joint Health & Wellbeing Strategy 2023 – 2028 (A copy of the presentation is attached to the signed minutes). The new health and social care landscape had been shaped by the introduction and implementation of the Health and Social Care Act 2022 which had brought in a new system to govern regional and local NHS bodies. This structure was the introduction of the Integrated Care Systems (ICS), of which local Integrated Care Boards (ICB) and Integrated Care Partnership (ICP) formed two key components. The new strategy was rooted in this new structure. The Public Health Partnership and Governance Lead then listed some general feedback they had received from hosting a development session. The general message was that the Health and Well Being Together Board needed to be more integrated into the local situation. In addition as to how complex the makeup of healthcare locally was, which meant that the Board needed to have greater clarity and focus on its priorities. Pathways could become disjointed across the city’s healthcare due to the complexity. Priorities were developed through gathering data through multiple targeted surveys, as well as utilising broader City wide data and Partner consultation. An aim to reduce health inequalities for new-borns was discussed, with a 1001 first days strategy which included health support for parents. Reducing harm caused by alcohol, drug and other addictions (such as gambling) was another “high-level ambition”, as well as “getting people moving more”, policies to encourage physical activity by the people of Wolverhampton to improve health. Improving the City’s mental health was another priority.

A Councillor asked if the terminologies used could be changed and made more simply, he cited “place based” as a term he disliked and suggested alternatives.

The Director of Public Health stated he felt people cared less about what terminologies were used and more about receiving good quality joined up healthcare when they needed it. He referenced the statistics which showed Wolverhampton’s alcohol induced death statistics being higher than the national average and contrasted this with Wolverhampton’s healthcare support for alcoholics which had higher success rates than the national average. He said this showed a joined up approach was required as environment played a strong role in reinforcing alcoholism which was why it was important to take up the approach set out in the Health and Well Being Strategy.

A Councillor referred to the report and said she couldn’t see where the voice of a Secondary or Primary School head teacher would be heard. She enquired where their voices would come in and be heard, within the new structure.

The Public Health Partnership and Governance Lead stated that a sub board called the Children and Families Together Board had head teachers and youth representatives on it.

A Councillor referred to the report, where it discussed “the seamless transition from child to adult care services” and stated she had concerns about how this system worked during the transition of someone from  ...  view the full minutes text for item 6.

[Healthwatch to deliver report to the panel]

The Healthwatch Engagement Officer informed the Panel that Healthwatch had carried out a survey between the 24^th and 26^th May 2023 with patients at the Urology services department, specifically to capture their experiences of the service and to see if they were aware of the service merger between Wolverhampton and Walsall Urology services.  38 surveys were conducted. People aged 66 to 70 and 76 to 80 account for the highest number of patients, with more men than women using the service. With the ethnicity primarily being white British. 22 people said the service was “good”, 6 people said “very good”, 7 said “satisfactory” and 1 person said “very bad”. The “very bad” rating was due to the patient not being informed they needed to bring a urine sample prior to the appointment, causing them to have to spend a long time in the hospital drinking water. The majority of patients stated that the department was not easy to find, car was the most common form of transport used, with comments stating that parking on the sites were inadequate and very expensive. Most patients stated they would prefer to be seen at New Cross, Wolverhampton over the Manor, Walsall.  All patients stated they were not aware of the service merger.  Overall feedback was that the service was mostly good but improvements needed to be made on department location awareness, travel options and parking availability/cost.

The Vice-Chair stated he enjoyed the report because it was simple and to the point, with gaps spotted which provided good scrutiny. He referenced a friend of his who was black Afro-Caribbean, suffering from prostate cancer; he stated statistically this community were more likely to suffer from prostate cancer at a younger age and wanted to know if any focus in future reports could look at racial disparities/willingness to attend healthcare.

A Councillor referred to the report and a quote where wheelchair accessibility was raised. She discussed the difficulties wheelchair users had in accessibility and travel and wanted more focus on this area of improvements; for example increasing blue badge spaces at the hospital car park.

The Chair agreed with and re-emphasised the points of the Panel, and especially highlighted and focused on the car parks issue. She wanted the Royal Wolverhampton Trust to conduct a report to bring back to the Panel in the future on car park improvements.

The Chief Executive Officer of the RWT agreed with the Chair that the car parking situation was bad. He said there were no quick fixes and that it would take at least 6 months to try improve it.

The Manager for Healthwatch Wolverhampton asked if there was a role public transport could play in strategy to offer an alternative to cars, for environmental purposes.

The Chair added that perhaps the Royal Wolverhampton NHS Trust could utilise a employee specific transport program to reduce the use of cars in employees which would free up parking spaces.

The Chief Executive Officer of the RWT stated that they  ...  view the full minutes text for item 7.