Agenda and minutes

Health Scrutiny Panel
Thursday, 6th June, 2019 1.30 pm

Venue: Committee Room 3 - Civic Centre, St Peter's Square, Wolverhampton WV1 1SH

Contact: Martin Stevens  Tel: 01902 550947 or Email: martin.stevens@wolverhampton.gov.uk

Items
No. Item

1.

Apologies

[To receive any apologies for absence]. 

Minutes:

An apology for absence was received from Tracey Cresswell. 

2.

Declarations of Interest

[To receive any declarations of interest]. 

Minutes:

There were no declarations of interest. 

3.

Minutes of previous meeting pdf icon PDF 320 KB

[To approve the minutes of the meeting held on 21 March 2019 as a correct record.]

 

Minutes:

The minutes of the meeting held on 21 March 2019 were confirmed as a correct record. 

 

4.

Matters Arising

[To consider any matters arising from the minutes.]

 

Minutes:

Clarification was sought on the term “gaming,” which was used in the minutes of the previous meeting, which the Scrutiny Officer explained. 

 

Healthwatch Chair and Panel Member, Sheila Gill referred to the section in the minutes where the Chief Executive of the Royal Wolverhampton Trust had invited Healthwatch representatives to talk to staff working in cancer treatment services about pathways and support.  She stated that this had not taken place and asked if the Panel could facilitate the process.  The Scrutiny Officer, with the endorsement of the Panel, gave an undertaking to help. 

 

5.

Public Health Performance Report pdf icon PDF 296 KB

[The receive a report on an overview of Public Health performance for the year 2018-2019.  The report details some key areas of work undertaken during 2018-2019, notes some of the challenges and successes throughout the year and seeks discussion and feedback from the Panel].

 

Additional documents:

Minutes:

The Director for Public Health presented a performance report on Public Health for the year 2018-2019.  To achieve the ambitious targets detailed in the vision, Public Health had focussed on different approaches to issues where traditional approaches had been unsuccessful in achieving change.  He outlined some of the priorities in the Public Health Vision, as detailed within the report.  Critical to achieving overall success was ensuring a good start to life, having a good education, obtaining skills and good employment, living in quality housing, and living within a good community.  If all of these elements could be achieved for a person, the probability was that health campaigns on matters such as obesity and smoking would not be required as people would be educated and comfortable enough to make the right decisions.

 

The Director for Public Health remarked that NHS health checks performance had significantly improved in the last year.  NHS checks were now solely provided through primary care.  Through closer collaborative working with Wolverhampton Clinical Commissioning Group (CCG), Primary Care Group Managers and GP Practice Staff across the City and a complete review of the system there had been an unprecedented rise in the access and uptake of NHS health checks.  Wolverhampton had gone from the bottom 8% in the country to the top quartile in the past year.  This meant health problems could be identified earlier with ultimately better health outcomes achieved.

 

The Director for Public Health commented that they had been working more in partnership rather than the usual commissioner provider relationship, they previously had with the Royal Wolverhampton NHS Trust.  They were working on getting the basics right on health visitor checks and school nursing.  Performance in this area was at its best since Public Health had moved back into the Local Authority in 2013.  On the matter of rough sleeping he commented there had been 33 people sleeping rough as of last May.  Bucking the national trend, the number had been driven down to 16 people as of the present day.  Rough sleepers would be provided accommodation if they sought help.   

 

The Director for Public Health stated that they had achieved the best coverage in flu vaccinations in schools since Public Health had moved back to the local authority in 2013.  There was also more coverage within social care settings than before and the lowest number of outbreaks of flu in social care settings had been achieved in the last year.  Public Health had helped to shape the ICS (Integrated Care System), working with the CCG and NHS Trust.  Partnership working was critical to addressing the health problems faced by the City.  Earlier in the month they had solidified a joint intelligence unit for the City to help all partners make better decisions through the flow of information on the health of the population of the City.

 

The Director for Public Health remarked that they had undertaken considerable more work with the Police on Community Safety.  They had obtained some pump prime funding for intervention work  ...  view the full minutes text for item 5.

6.

Update on Suicide Prevention pdf icon PDF 645 KB

[To receive an update report on suicide prevention].

Additional documents:

Minutes:

The outgoing Chair of the Suicide Prevention Stakeholder Forum presented an update report on suicide prevention.  The incoming Chair of the Forum had sent her apologies due to sustaining an injury.  He had been the Chair of the Forum for three years since its initial inception.  His background was working with the Local Samaritans, he also had a regional role with the Samaritans working with the twelve prisons in the West Midlands Region.

 

The outgoing Chair of the Suicide Prevention Stakeholder Forum remarked that nationally there had been 5821 suicides in the year 2017.  This equated to 16 suicides a day.  It was estimated that there were ten times as many suicides attempts as completed suicides.  Nationally, approximately 75% of people who took their own life were male.  The peek for men was age 45-49 and for women age 50-54.  72% of the people had not been in contact with secondary mental health services in the year prior to taking their own life.  It was estimated that the direct and indirect cost to the economy of one suicide equated to £1.7 million.  It was the single biggest killer of men under the age of 45 in the country.  On a local level there had been 25 suicides in Wolverhampton in 2017.  Broadly there had been a downward trend since 2002.  Slightly more men had taken their own life than women in Wolverhampton in 2017.

 

The outgoing Chair of the Suicide Prevention Stakeholder Forum commented that the national strategy had two key aims, to achieve a reduction in the suicide rate in the general population of the country and to offer better support for those bereaved or effected by suicide.  The national report recommended 60 areas where organisations should be placing their efforts, particularly focusing around suicide audits and suicide prevention action plans as part of a multi-agency approach.  The Centre for Public Scrutiny had produced some guidance on the scrutiny of suicide prevention work.  The report circulated with the agenda answered the questions that the Centre for Public Scrutiny had suggested should be asked by a Scrutiny Panel.  He supported the Centre for Public Scrutiny Guidance suggestions on the ten areas that a Scrutiny Panel should seek answers. 

 

The outgoing Chair of the Suicide Prevention Stakeholder Forum stated that in 2014-2015 a comprehensive Needs Assessment had been carried out by a Consultant in Public Health.  The assessment looked at the perceived needs, the services available, where the gaps were and what could be done to rectify them.  The Needs Assessment had resulted in a strategy being drawn up which was refreshed on an annual basis.  The Forum’s work was very much driven by the strategy.  It was important to sustain momentum in suicide prevention work.  He was pleased that the Forum was independently Chaired, which helped to cement the concept that a multi-agency approach was required, rather than suicide prevention being seen as solely a Local Authority function in conjunction with a limited amount of certain partners.  There were now  ...  view the full minutes text for item 6.

7.

Transition from Children's to Adults' Services for Young People pdf icon PDF 390 KB

[To receive a report from, The Royal Wolverhampton NHS Trust, on the transition arrangements from Children’s to Adults’ health services]. 

Additional documents:

Minutes:

The Consultant Paediatrician at Newcross Hospital presented a report on the transition from children’s’ to adults’ services for young people.  At Newcross there were some areas where there was very good practice, such as the Diabetes Transition Service and the Epilepsy Transition Service.  They were looking at introducing a Trust wide strategy for transition which was based on NICE Guidance along with some of the relevant legislation.  It was being developed with support from adults’ and childrens services in collaboration with parents.  Transition was important to achieving good outcomes.  She gave a presentation, the slides of which, containing the information she relayed to the Panel, were sent out with the agenda.  As part of the changes they were piloting the concept of health passports which contained substantial information on the young person.

 

A Councillor relayed to the Panel his own personal experience of having a child who had been receiving treatment from the National Health Service and had transitioned from children to adult services.  It had been a challenging and difficult time for the family. 

 

The Consultant Paediatrician at Newcross Hospital raised the importance of adult services liaising with the GP of someone who had transitioned to adult services of which the health professionals had no personal knowledge.  A Councillor commented that he had personal experience of GPs not being as helpful as perhaps they could have been, his experience had been mixed.

 

The Director for Adult Services stressed the importance of a system wide strategy as many organisations were involved in a person’s life.  He was cautious of the NHS Trust having their own standalone transition strategy and wanted to ensure that the processes and systems could work collectively as effectively as possible.  He was keen to ensure that the Trust were supported in their work by the wider sector, citing special educational needs as an example.  The Consultant Paediatrician at Newcross Hospital responded that there was a special educational needs and disability health workstream which had representation from many partners.  More generally there was also the Centre Partnership Board which was looking at the work being done to prepare children for adult services.  She was keen to ensure that the strategy worked in synergy with other partners.

 

A Panel Member asked if it was an absolute requirement that when a person reached 18 that they had to transfer to adult services.  The Consultant Paediatrician responded that some people over the age of 18 were kept in children’s clinics if they were still at school.  The reason why a person normally transitioned to an adult ward at 18 was because at that age you were legally classed as an adult with different rights to a child. 

 

A Member of the Panel asked how much weight was put on a person’s opinion if they were under the age of 18 and in particular if their wishes were different to those of their parents.  The Consultant Paediatrician responded that they did take into account the child’s opinion and it  ...  view the full minutes text for item 7.

8.

Update on Child Death Overview Panel pdf icon PDF 306 KB

[To receive a report on the Child Death Overview Panel]. 

Minutes:

The Consultant in Public Health presented a report updating the Panel on the Child Death Overview Panel.  The way child deaths were reviewed was a process which followed national guidance and new guidance had been released last year.  They were currently in a state of transition to make sure they complied with the new guidance.  She was pleased to report that Walsall, Wolverhampton, Sandwell and Dudley were working jointly together on the project.  She believed that the new national guidance was a positive change.  They were in the process of appointing a Black Country Child Death Overview Panel Co-ordinator.  They had adopted a system known as e-CDOP which was a cost effective, secure, flexible and web-based solution which allowed the Child Death Overview Panel process to be managed efficiently, with effective and secure sharing of multi-agency information.

 

The Chair congratulated Public Health on working collaboratively with other Black Country Local Authorities alongside health partners on the Child Death Overview Panel.

 

A Panel Member asked about data capturing surrounding learning disabilities and social economic factors which may have had a bearing on the death of a child.  The Director for Public Health responded that the really important question was about ensuring that the data collected and the themes arising were put to good use in the appropriate manner and directed to the right area within the system.  The new system e-CDOP was a very effective data-based system and some of the data captured was of an excellent standard.     

 

A Member of the Panel asked about how the new role of Medical Examiner had affected the processes.  The Consultant in Public Health responded that the new processes were not expected to commence until 1 July 2019, so the impact of the new posts would not be felt until 6-12 months.

 

Resolved: That the Health Scrutiny Panel receives a report every twelve months on the Child Death Overview Panel.  

9.

Health Scrutiny Work Programme pdf icon PDF 285 KB

[To consider the lastest version of the Health Scrutiny Work Programme]. 

Minutes:

A Member of the Panel asked for a verbal update on Brexit to be given at the next meeting of the Panel.  The Panel agreed to add it to the Work Programme.

 

The Chair raised the matter of site visits.  The Scrutiny Officer confirmed that there would be a site visit arranged to West Park Hospital at the end of September.  The Chief Executive of the Royal Wolverhampton NHS Trust had also agreed that the Panel could have a site visit to Cancer Services at Newcross Hospital and A&E should they wish to do so. 

 

The Health Scrutiny Work Programme was agreed.