Agenda and minutes

An apology for absence was received from Cllr Greg Brackenridge. 

There were no declarations of interest. 

[To approve the minutes of the meeting held on 8 July as a correct record]. 

Resolved: The minutes of the Health Scrutiny Panel meeting held on 8 July 2021 were confirmed as a correct record. 

[To approve the minutes of the Special Meeting held on 29 July 2021 as a correct record.]

Resolved: That the minutes of the Special Health Scrutiny Panel meeting held on 29 July 2021 be approved as a correct record subject to the resolution being clearer that the information pack should contain details about access to transport options to Walsall Manor Hospital. 

[To consider the Healthwatch Wolverhampton Annual Report 2020-2021]. 

The Manager of Healthwatch Wolverhampton presented the Healthwatch Wolverhampton Annual Report 2020-2021 to the Panel. 

The Chair referred to the point in the annual report regarding GP communication with patients being an issue before and during the pandemic.  She would have liked to have seen precise details in the report regarding which surgeries they had received answers from.  She proposed a Special Health Scrutiny Panel to be held in December 2021 to consider Primary Care appointments.  She asked if Healthwatch could complete an audit on Tuesdays and Thursdays at GP surgeries to see how easy it was to contact the surgery and arrange an appointment. 

The Healthwatch Manager offered to share the report on GP communication which had been completed a few years ago. She agreed to contact GP surgeries ready for the Special meeting which would take place in December.  

A Member of the Panel referred to the reference in the Annual Report of an underspend of approximately £19,000.  He also referred to the pilot mental health scheme which some schools in the City were participating in.  He stressed the importance of support mechanisms for youngsters.  He asked why there was an underspend when there were situations which needed improvement such as young people’s mental health and emotional wellbeing. 

The Healthwatch Manager confirmed there was an underspend, which would be transferred into next year’s finances.  Healthwatch Wolverhampton did work quite closely with the colleges on the matter of mental health.  She would come back to the Panel on why there was an underspend and why it had not been spent on an area of priority need.

A Panel Member referred to the reference in the report which stated that Healthwatch had directly helped 845 people.  Of the total funding Healthwatch received, that worked out as £2,300 per person.  He would have hoped that Healthwatch could have helped more people directly particularly during the Covid pandemic.

The Healthwatch Manager responded that it was difficult for Healthwatch to fully engage with the public during the Covid pandemic.  Not everyone was able to engage with digital platforms.  She offered for the Managing Director of Engaging Communities Solutions (ECS) to come back to the Panel on matters regarding finance.  It was however true that the bulk of the funding received was spent on staffing costs.  Whilst 845 people had been directly helped, this did not represent the amount of times Healthwatch may have contacted them, for example some people could have had 10-15 contacts.

A Panel Member commented that an underspend was not necessarily a bad thing for Healthwatch to have.  It could show prudent financial management during a difficult time from Covid.  They stated that Healthwatch had done a tremendous job in difficult circumstances, adding that a lot of people had been directly helped.  She asked the representatives from Healthwatch to comment on their links with Wolverhampton’s Voluntary Sector Council. 

The Healthwatch Manager responded that the Voluntary Sector Council had provided them with a list of names of people to call for  ...  view the full minutes text for item 5.

[To consider, The Royal Wolverhampton NHS Trust – Quality Account 2020-2021]. 

The Deputy Chief Nurse from the Royal Wolverhampton NHS Trust presented the Quality Account 2020-2021 for the Trust.  A copy of the slides are attached to the signed minutes.  She thanked the Chair for her statement she had provided on behalf of the Panel, which had been included in the Quality Accounts.  Three priorities were addressed in the Quality Accounts, Workforce, Safe Care and Patient Experience.

The Vice-Chair referred to the performance of the Trust against national operational standards.  In the report, of the 23 columns, 5 were in the green (meeting target indicator) and 18 were in the red (not meeting target indicator).  He completely understood the challenges of Covid.  The one area that particularly stood out was the two weeks wait for breast symptomatic patients indicator.  The performance in 2020/21 was 51.14%, the target for the year was 93%.  He asked what measures the Trust were taking to improve performance in this area.   He thanked New Cross Hospital for their services. 

The Deputy Chief Nurse responded that performance in the two weeks wait for breast symptomatic patients was now much improved.  They had been working collaboratively with other hospitals in the Black Country and West Birmingham CCG area. 

Panel Members thanked the representatives from the Trust for the report, which it was clear a great deal effort had been put into.

A Panel Member referred to the Trust’s partnership with the private company Babylon and asked for comment on what they saw as the private sector becoming more involved with the National Health Service.  They asked how the Trust could address fundamental issues of inequality such as the digital divide and people from poorer backgrounds more likely to have health problems and live shorter lives.  They had a particular interest in how Female Genital Mutilation (FGM) was reported by hospitals because medics were often the first to become aware of the occurrence.  They asked about the overall process in managing FGM including where it was seen within the Trust, how it was reported and who was informed.  They commented that end of life care in the community was more complicated than within a hospital setting.  They believed there was often a disconnect between the care a person received in the community and what their primary care doctor or trust staff felt was appropriate.

The Chair requested that the question regarding Babylon be deferred to a special Health Scrutiny Panel meeting on Primary Care planned for December.  The Deputy Chief Nurse commented that inequalities was a huge challenge for the Trust.  They had tried to improve their understanding of the situation by an analysis of data, such as looking at geographical locations of patients where inequalities were more prevalent.  The Trust were looking at inequalities based on deprivation and ethnicity.  They were analysing urgent and routine healthcare pathways.  They were also looking at other inequalities such as learning disabilities and how they performed against the standard. They were analysing key planned pathways, particularly focussing on hip arthritis, Chronic Obstructive  ...  view the full minutes text for item 6.

[To receive a presentation from the Black Country and West Birmingham CCG on Primary Care Access.  There will also be an opportunity for Panel Members to ask general questions on the matter of Primary Care in Wolverhampton]. 

The Managing Director of the Wolverhampton area of the Black Country and West Birmingham CCG introduced the item.  He explained that they had been asked to focus on the issue of Primary Care Access.  He commented that during the pandemic lockdown demand for GP services had been reduced due to anxiety from patients about contacting their GP.  This meant there would now be people presenting with issues to their GP that they ordinarily would have brought earlier.  They had heard the concerns raised by the public regarding Primary Care Access, this was through direct contact, Healthwatch, Councillors and Members of Parliament.  The CCG understood the frustration of patients who wanted an appointment with their GP but were unable to obtain one when they needed.  Demand for services was at a heightened level. 

The Managing Director of the Wolverhampton area of the Black Country and West Birmingham CCG commented that GP practices also faced additional pressures of delivering the vaccine programme.  As Covid was still prevalent practices were having to continue to deliver services in a Covid safe environment.  This did change their operating procedures including how they managed access to their surgeries and the telephone triage model. 

The Managing Director of the Wolverhampton area of the Black Country and West Birmingham CCG displayed a graph which showed that from April 2020 there was a significant reduction in appointment numbers.  Appointments had then built back up again slowly over the course of the year.  Levels of activity in Primary Care were now at the same level or above that prior to the pandemic.  Before the pandemic the vast majority of appointments were face to face at approximately 86%.  In June 2020 the overall levels of GP activity had reduced and there was a much smaller ratio of face to face appointments and a higher level of telephone consultation.  In June 2021, levels of activity had significantly increased.  The proportion of face to face appointments had increased but had not returned to the same levels as in January 2020.  They did not necessarily expect face to face appointments to return to the level they were pre-pandemic because of the different ways services could now be offered.    In August of 2021, 57% of appointments were being seen face to face.  This local figure was also the same as the national figure.   Even at the height of the pandemic GPs were still seeing some people face to face. 

The Managing Director of the Wolverhampton area of the Black Country and West Birmingham CCG showed a slide from the national LMC (Local Medical Committees) snapshot survey from March 2021.  69% of patients accessing GP services were now considered complex.  Consequently over 50% of GPs had advised of increasing consultation times.  The CCG did not receive routine data of the number of calls being received by GP practices.  However, at Dr Reehana’s practice, Health and Beyond group, call volumes were up 165% in June, 80% in July and 30% in August, compared to the same months  ...  view the full minutes text for item 7.

[The date of the next scheduled Health Scrutiny Panel is Thursday, 10 February 2022 at 1:30pm]. 

The date of the next scheduled meeting was 10 February 2022.  There would however be a Special Health Scrutiny Panel meeting on Primary Care at some point in December 2021.

The meeting closed at 3:43pm.