Agenda and minutes

[To receive any apologies for absence]. 

Apologies for absence were received from Panel Members, Cllr Bhupinder Gakhal and Dana Tooby.  Panel Member, Cllr Obaida Ahmed sent her apologies for part of the meeting.

The Portfolio Holder for Adults, Cllr Linda Leach sent her apologies. 

David Watts, Director of Adult Services sent his apologies for part of the meeting. 

Vanessa Whatley, Deputy Chief Nurse, the Royal Wolverhampton NHS Trust sent her apologies to the meeting. 

[To receive any declarations of interest]. 

There were no declarations of interest. 

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

The minutes of the previous Health Scrutiny Panel meeting held on 23 July 2020 were approved as a correct record. 

[To consider any matters arising from the minutes.]

There were no matters arising from the minutes of the previous meeting. 

[For Health Scrutiny Panel Members to ask questions of Health Partners relating to Covid-19]. 

A Panel Member asked how the restarting of services was going at, The Royal Wolverhampton NHS Trust and in particular cancer testing and cancer treatment.  In addition, she understood the Breast Surgery Unit was being considered for a possible move to Cannock Hospital, she asked for the reasons and whether this potential move was supported by the staff concerned.  The Chief Executive of the Royal Wolverhampton NHS Trust responded that cancer services had been restored, but it would be a challenge for at least the next six months in relation to diagnostics.  Endoscopies were a particular problem, where they were working at best at 63% efficiency.  They would not be able to return to the efficiency of pre-Covid levels until social distancing had been halted.  He had earlier in the week had to close Cannock Hospital due to a Surgeon and Junior Doctor testing positive for Covid-19.  He had sent most of the theatre staff home to self-isolate.  It was his intention to move breast cancer services to Cannock Hospital and the Nuffield.  It was however on hold at the present time due to the fact that Cannock was no longer a clean site.  They were still investigating how Covid-19 had entered the hospital.  He had to move the service due to capacity reasons and was putting the patients first.  All services were under pressure due to Covid-19, deep cleaning was required after every endoscopy.  There was also a world-wide shortage of equipment, making it harder to expand service areas. 

The Managing Director of Wolverhampton CCG stated that when the pandemic had commenced there had been a significant reduction in the number of cancer referrals into New Cross Hospital.  At the height of the pandemic cancer referrals had reduced to 25% of normal levels.  The referral rate had now recovered to normal levels for the time of year.  Outpatient activity was also at usual pre Covid-19 levels.  He echoed the points made by the Chief Executive of the Royal Wolverhampton NHS Trust that this was putting pressure on services at the Trust.   They were working closely with the Trust and other Trusts across the STP (Sustainability and Transformation Partnership) footprint to help mitigate the pressures as much as possible.  It would be a continuing challenge over the coming months.

The Chair asked if Health partners could explain their latest plans for asymptomatic testing, particularly in key sectors such as within Hospitals, Social Care and Schools.  The Director for Public Health responded that asymptomatic testing was a potential ambition at a national level in the future.  There was more of a narrative at the present time to population level testing.  There was currently a high demand for testing, which was linked to the fact that children had returned to school.  There was currently an accelerating rate of Covid-19 infections in the population of Wolverhampton.  Two weeks earlier, there had been 8-10 cases per 100,000 but it was now approximately 50 cases per 100,000.  This would further increase the demand  ...  view the full minutes text for item 5.

[To Scrutinise the future commissioning proposals for the Black Country and West Birmingham area]. 

The Managing Director of Wolverhampton CCG introduced the report on the CCG Merger proposals.  He stated that the CCG in Wolverhampton had been very successful and had been rated as outstanding in the last four years by NHS England.  There was a changing landscape in the NHS, with the development of Sustainability Transformation Partnerships (STP) and Integrated Care Systems (ICS).  The expectation in national policy was that the ICS would play a key role in how the systems would work and that within the ICS there would be a single Commissioning voice.  In order for Wolverhampton to be a successful Commissioner it needed to be part of an Integrated Care System with the national expectation of there being one single CCG across the Black Country and West Birmingham.  As part of any Black Country and West Birmingham CCG, they did not want to lose the critical local relationships in Wolverhampton with General Practice, the local public, the local authority and local providers.  Any future CCG would be organised with local decision making critical to its governance structure.  They would continue to have a clinically led decision making body in Wolverhampton which would have governance responsibility.  There would also be a management team, led by himself, which would support the decision making body and provide support to partners and the public. 

The Managing Director of Wolverhampton CCG remarked that the Panel had previously asked for a list of benefits that a formal merger of the four CCGs would provide.  Section 3.1 of the report circulated with the agenda listed the benefits.  A clear benefit was the advantages of working at scale and collaborating, which could benefit Wolverhampton, but keeping certain elements which worked best at a local level within Wolverhampton. 

The Chair of Wolverhampton’s CCG Governing Body stated that whilst there were benefits of working at scale, including cost savings which could be re-invested into patient care, it was important to ensure that they did not become distant from local decision making and local care needs.  There would be a local Wolverhampton based structure including a local Office, local GP and patient representation on the local board would continue irrespective of there being a single organisation at system level. 

A Member of the Panel commented that it was hard to argue against an Integrated Care System and she questioned why this had not been put forward in previous decades.  She also highlighted that reducing duplication and costs and increasing partnership working were all beneficial.  She commented that smaller voluntary sector providers tended to lose some of their influence when organisations became larger.  She sounded a word of caution that they needed to have good communication with them to ensure local need was fully taken into account. 

The Managing Director of the CCG responded that he agreed with the Member on the importance of the voluntary and community sector.  Ensuring they had a voice would be very much the responsibility of the local Committee and team.  The structures that they were currently  ...  view the full minutes text for item 6.

[To consider the Healthwatch Annual Report 2019-2020]. 

The Healthwatch Manager presented the Healthwatch Annual Report 2019-2020.  The Chair and Vice-Chair had submitted a total of eight advance questions to the Healthwatch Manager for a response to be given at the meetings.  The first question was, “the Annual Report refers to making 192 recommendations for improvement, do you keep track on whether these recommendations have been implemented and do you publish the outcomes?”  The Healthwatch Manager responded that as part of their 2020-2021 enter and view visits, they were planning to conduct re-visits. They had however suspended enter and view visits in March 2020 due to Covid-19 and ensuring the safety of volunteers, many of which fell in the vulnerable category and for the safety of patients.  It was later recommended by Healthwatch England to suspend all enter and view activities and it still remained their advice.  Their parent company Engaging Communities Solutions were exploring ways that might enable people living and using services to share their stories using digital technology.  More generally some of the recommendations effected the wider Black Country area and so there was a need to liaise with other areas when following up recommendations.  For other report recommendations, they would form part of their work plan for next year. 

The second question submitted was, “can you explain how you choose which places to “enter and view” and the role of the Healthwatch Advisory Board in this process?” The Healthwatch Manager responded that there were various ways the enter and view locations were chosen.  The location choices were based on the intelligence they received through a number of channels including patient experience and feedback. They worked with the quality teams at the local authority, CCG and CQC and were currently meeting them virtually.  She advised that the Healthwatch Advisory Board (HAB) must approve the decision on which visits should be undertaken and she added that they had recently refreshed the decision making policy and process to ensure that the process in which a visit is determined and agreed upon is fully transparent.  The rationale behind the decision was recorded in their HAB meeting minutes, which was a public document available on their website.  However, whilst they always tried to plan ahead and obtain HAB approval on premises to visit, there were some occasions when an urgent visit was required, as the Healthwatch Manager she could make a recommendation to the HAB Chair if time was of the essence.  The Chair could agree the visit as a Chair’s action, which would be recorded retrospectively in the HAB meeting minutes at the next available meeting.  In reality this only happened on rare occasions. 

The third question which had been submitted was, “what are your plans for “Enter and View” because it was paused during Covid-19?”  The Healthwatch Manager responded that it was currently paused, but this had not prevented them engaging with the public via virtual engagement meetings, coffee mornings, and their annual planning meeting. 

The Chair had submitted the question, “can you explain the process  ...  view the full minutes text for item 7.

[To receive a presentation on the Connected City Scrutiny Theme agreed at the Council’s Scrutiny Board]. 

The Scrutiny and Systems Manager gave a presentation on “Connected City.” A Cross cutting them had been agreed by City of Wolverhampton Council’s Scrutiny Board at the meeting held on Tuesday, 14 July 2020.  Scrutiny Board had asked Scrutiny Panels to consider connectivity and digital considerations as part of all items addressed in the Work Programme.  The outcomes and recommendations from the Scrutiny Panels would then be fed back to Scrutiny Board to unify into one comprehensive report based on the connected city theme.  The final report and any recommendations made would then be submitted to City of Wolverhampton Council’s Cabinet for consideration.  She presented a slide on the digital revolution in Wolverhampton.  Change was progressing fast and it was important to keep up support for the citizens of Wolverhampton.  The important question for the Health Scrutiny Panel to continue to ask was, “How do we use and engage connectivity and digital means to help support the areas that fall under the remit of the Panel.”

The Vice Chair commented that it was important for Members to take into account digital and connectivity when the Health Scrutiny Panel looked at items throughout the municipal year.       

The future confirmed meeting dates of the Health Scrutiny Panel are as follows:-

19 November 2020 at 1:30pm

14 January 2021 at 1:30pm

24 March 2021 at 1:30pm

The future meeting dates of the Health Scrutiny Panel were confirmed as follows: -

19 November 2020 at 1:30pm

14 January 2021 at 1:30pm

24 March 2021 at 1:30pm

The meeting closed at 4:12pm.