Agenda and minutes

[To receive any apologies for absence]. 

An apology was received from Panel Member, Cllr Milkinderpal Jaspal.

Cllr Jasbir Jaspal sent her apologies as Cabinet Member for Health & Wellbeing.

Professor David Loughton (Chief Executive of Royal Wolverhampton NHS Trust) and Marsha Foster (Chief Executive of Black Country Healthcare NHS Foundation Trust) also sent their apologies.

[To receive any declarations of interest]. 

There were no declarations of interest.

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

Resolved: That the minutes of 12 December 2022 be approved as a correct record.

[To receive a verbal report on the latest position regarding, One Wolverhampton Priorities]. 

The Chair invited the Wolverhampton Managing Director of the Integrated Care Board (ICB) to give a verbal update; The Chair specifically wanted an update on how the Royal Wolverhampton NHS Trust was performing against its targets.

The Wolverhampton Managing Director ICB informed the Panel that the ICB had 6 Strategic Working Groups who had been meeting to discuss their own internal scrutiny. He reported that there had been progress across all 6 groups. He explained the One Wolverhampton Board was used by them to have oversight over their contributions to the Black Country community transformation projects over mental health work. The One Wolverhampton Board was used to plan and co-ordinate the Trust’s response to the winter period. He felt this benefitted the partnership and improved their working relationships and strategies, highlighting work done around Social Care Discharge strategies in particular.

The Director of Public Health stated that he felt the One Wolverhampton Board’s meeting was one where the partners and Strategic Working Groups remained critical towards their on going practices for the betterment of their healthcare service. They had expanded health checks between 40 to 75 year olds, people received invites and could choose to attend the health checks which were carried out in some General Practices and the Mander Centre. He stated that Royal Wolverhampton Trust had kept its vaccination centre in the Mander Centre for Covid-19 open and had delivered over 20,000 vaccinations; he believed this to be a solid foundation to build upon for future healthcare delivery strategies given the scale of people treated. The Director of Public Health told the Panel that the Royal Wolverhampton Trust had launched pilot schemes for screening heart disease and cancer checks and were trying to close the gap between Wolverhampton and other service areas on that health issue. This was a strategic decision to attempt to diagnose conditions early and treat them more effectively. He felt the partnership working enabled them to cover a broader scope of inter-related strategies for improving the health and healthcare of the local population.

The Group Chief Strategy Officer of Royal Wolverhampton NHS Trust said that the data across the City gave them a very clear picture of what the issues were and this was the basis for their Transformation Agenda going forwards. He also stated the importance of maintaining current healthcare service flows and making sure all the City’s residents were receiving the best healthcare possible. The Wolverhampton One Board is there to look at prevention, as well as post healthcare service delivery and outcomes. The next stage was providing the data to the Strategic Working Groups so that they would be able to tailor their work plans better.

The Chair asked how many patients were awaiting discharge from New Cross Hospital or other Hospitals run by the Royal Wolverhampton Trust and asked how many of those lived outside of the coverage of Wolverhampton Council (responsibility of other Councils).The Director of Adult Services responded there were 76 people waiting for discharge, 14 were with  ...  view the full minutes text for item 4.

[To receive a monitoring report on Urology Services following the merger with Walsall]. 

The Chair invited the Group Chief Strategy Officer for the Royal Wolverhampton Trust to present the report.

The Group Chief Strategy Officer stated that the aim was that the service would go live by 1 April 2023. He explained that they had planned for slippage which could result from the combination of the services between Walsall and Wolverhampton. Areas where issues could arise could occur in data migration and digital transfer operations. There were currently 10,000 patient data items waiting to be transferred and tests were being done to ensure digital systems were integrated and working, he was confident they would meet the deadline set. The Single On-Call Rota was still an outstanding item to be done, as was the Patient Tracking List , they were however, on time in the schedule of work to be done. Transfer of None Elective work had already commenced and issues were identified and reviewed to make sure the right patients were being admitted. The Group Chief Strategy Officer informed the Panel that the Trust had test ran outpatient clinics at weekends to establish if the service would run smoothly and reported that all tests were successful. Staffing levels were on track, with only 3 vacancies left which were due to be recruited. An advisory was given on the known mitigations and known potential issues around data transfer. A communication plan was in place, which included patients and staff. Once this was launched, patients would be able to book in online and receive updates with no differences in quality of service during the transfer. They were requesting the Black Country Clinical Senate undertake a review of what the Trust had done as part of the Urology transfer. This was so the Trust could make sure they knew the operation was carried out as best as possible.

A Panel Member asked how the Trust knew if patients were managing their appointments on sites out of their normal area of coverage and if the Trust was monitoring it.

The Group Chief Strategy Officer answered that there was up to 20 percent capacity to enable those who could not travel further afield to have the service in Wolverhampton. He also stated that they were continuing to monitor this.

The Chair raised concerns around the transfer to online services, citing elderly people as an example of a part of the community who may not be able to use digital systems. The Chair wanted clarification as to how out-patient services are met with patients and what the criteria was in deciding that; the Chair also asked how the communication of changes was done.

The Group Chief Strategy Officer explained to the Panel that it was a choice based system and that they did have alternatives to digital. He stated that the criteria was not a catch all system as each patient has individual needs, judgements were made on a case by case basis. If patients could not travel, they had different options at the referral stage to discuss and  ...  view the full minutes text for item 5.

[To receive a report from Healthwatch Wolverhampton on their latest GP Practices telephone survey].   [Report is marked: To Follow]. 

[To receive a report from the Integrated Care Board on the latest developments in Primary Care].  [Report is marked: To Follow]. 

The Wolverhampton Managing Director ICB talked the Panel through the report, a copy of the presentation is attached to the signed minutes. Referencing section 3.4, the Wolverhampton Managing Director ICB noted that between July and November 2022 there had been an increase in the total number of appointments offered by the General Practice. He highlighted that most of the appointment increases between June and November were face-to-face appointments. He stated that all Primary Care Networks now offered additional hours for appointments which included evening appointments and appointments between 9 and 5 on weekends. For the winter period, the Trust had given extra funding to Primary Care Networks so that they could cover bank holidays.

The Chair invited Healthwatch to give their report and requested questions for both report items be given after, highlighting the related nature of the two reports for Scrutiny.

The Engagement Officer for Healthwatch began the presentation, a copy of the presentation is attached to the signed minutes. Healthwatch had found that a number of call handlers had not been made aware that Healthwatch would be calling and were unaware of their role. They reported that there had been noticeable improvement since their previous survey in the number of practices which were willing to participate, one had worsened. A large number had increased signposting practices to pharmacies. Other Primary Care Networks had not implemented a call waiting system since the previous survey and had in fact worsened in this area, one had not changed. The Healthwatch Engagement Officer recommended the Primary Care Networks raise awareness of the role that Healthwatch play, encourage GP participation, increase signposting to other services to reduce walk in pressures and review their call waiting systems to make improvements. The Engagement Officer for Healthwatch covered local practices from across different wards in terms of their engagement with Healthwatch and listed various averages in statistics. The Engagement Officer for Healthwatch invited the Health Scrutiny Panel to help ensure that recommendations were implemented and to further work to ensure partners are held accountable.

The Chair thanked everyone for their reports and presentations. She expressed disappointment that 22.7% of the local General Practitioners had refused to engage with Healthwatch.

The Manager of Healthwatch Wolverhampton added that the statistics would have been worse but she used discretion and contacted the practices back later on and explained who Healthwatch were and the legal obligations the NHS had to answer them. She further stated that if she had not done this, they would have had a lack of data, she believed this was down to a lack of training with the receptionists at the General Practices about who Healthwatch were.

A Councillor said he was concerned that staff did not know who Healthwatch were, given the consultations between partners that had been done. He said it was unacceptable and asked the Integrated Care Board how they could guarantee that the same issues would not occur again next time Healthwatch do another report.

The Wolverhampton Managing Director ICB answered that  ...  view the full minutes text for item 6.

[The date of the next scheduled Health Scrutiny Panel is 23 March 2023]. 

It was advised that the date of the next meeting is 23 March 2023 at 1.30pm.