Agenda and minutes

There were apologies from Vice-Chair, Cllr Paul Singh who was substituted by Cllr Bob Maddox.

Apologies were also received from Cllr Milkinderpal Jaspal and Cllr Rashpal Kaur.

Cabinet member Cllr Jasbir Jaspal gave apologies also.

There were no declarations of interest. 

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

Resolved: That the minutes of the meeting held on 29 June 2023 be approved as a correct record subject to a Member’s comment regarding the training for PPGs Chairs being still ongoing at the time of the meeting, rather than completed in full. 

The Healthwatch Managed informed that Panel that she had been told there was still ongoing issues occurring with PPG chairs. She said for balance she had heard some good practices had occurred, so it wasn’t all PGGs.

[Black Country Healthcare NHS Foundation Trust Adult Acute Service to deliver report to the Panel]

The Director of Governance for the Black Country Healthcare NHS Foundation Trust gave a presentation (a copy of which is attached to the signed minutes). He covered the context of the inspection and the report. The Care Quality Commission (CQC) carried out an unplanned inspection in response to the Acute wards for adults of working age and psychiatric intensive care units as a response to media reports. The results were published in March 2023, with the service overall rating being downgraded from a “good” rating to “requires improvement”. Identified good practice in the report included staff treating patients with compassion, understanding and kindness,  managers overseeing staff and giving appraisal, as well as staff following good safe guarding practices.  A number of areas were identified for improvement:

·       A need to focus on the management of medication and closer working with pharmacists.

·       Improve training rates in core skills

·       Consistency and quality of care-planning.

·       Recruit to vacancies within ward based MDT’s.

·       Continue work on the physical environment, refurbishment and removal of ligature points.

·       Ensure that patients receive planned 1:1’s and leave. 

·       Focus on awareness of new systems and teams within the Trust.

The Trust had received 10 must do actions and 5 should do actions detailed within the Care Quality Commission report and reproduced in the report presented to the Panel.  The Director of Governance for the Black Country Healthcare NHS Foundation Trust displayed a diagram to the Panel setting out the Governance framework within the service. Quarter 2 2023 – 2024 Actions included Must Do and Should Do Actions, of which some were complete, some had not been started and a number were off track.  The Trust met the CQC every quarter.

The Chair stated that following reports at Penn Hospital of failings in care towards vulnerable patients, the CQC conducted an unannounced inspection and downgraded the services rating from "good" to "Requires improvement". Staff were reported by the BBC to have informed the CQC rather than raise issues internally. She wanted to know if this was standard practice and if not, would the Trust be working on improving whistleblower safeguarding practices to ensure all staff could report concerns or issues with the service in a manner where their employment and standing was protected.

The Chief Operating Officer for the Black Country Healthcare NHS Foundation Trust replied that they operated a “Freedom to Speak Up” policy and that he felt the staff were quite open with the team being able to raise issues. He said staff were protected by anonymity if they chose to be and were not disciplined or dismissed if they raised issues.

The Director of Governance for the Black Country Healthcare NHS Foundation Trust stated that they worked with the CQC and were transparent with them in regard to the reported case. He said the Police were involved at their behest. He said that the Integrated Care Board had recognised that the Trust had had a challenging year but had commended the Trusts openness and transparency when dealing  ...  view the full minutes text for item 4.

[Maternity Services for Royal Wolverhampton NHS Trust to deliver a report to the Panel]

The Director of Midwifery Royal Wolverhampton NHS Trust stated that staff retainment and recruitment was an issue, as it was across the country. This had been largely a post-Covid phenomenon but was slowly changing and improving recently. The Royal Wolverhampton NHS Trust had 12 full time midwifery vacancies, but had had a successful recruitment campaign and had now recruited into all those vacancies. These new recruits were set to join in September and be established around December. The Trust was doing work with Black, Asian and ethnicity minority groups to try to reduce inequalities. Work was being done to promote healthy life styles and there was an aim to tackle obesity and smoking.

The Director of Midwifery Royal Wolverhampton NHS Trust commented that further funding from Public Health had been provided to recruit two healthy pregnancy advisors to support community mid wives and healthcare workers. There was a 62% success rate in booking pregnant women in who were within 10 weeks of their pregnancy, the national average was 59% and the RWT aimed to achieve 70% by December. A new self-referral service had been launched in July to help increase this, with 1000 women so far having self-referred themselves to the service. The service was judged as fully compliant with all 7 Ockenden immediate and essential actions. The Trust Maternity Services had achieved 4^th year in a row of the 10 safety actions.

The Chair asked how did the Trust promote early contact with General Practitioners to encourage engagement by pregnant women & people to visit within the first 10 weeks.

The Director of Midwifery Royal Wolverhampton NHS Trust replied that the Maternity Services encouraged women to engage with their midwife in the first instance, with the aim to get them to book in within the first 10 weeks in line with the national recommendation.

A Panel member referred to page 37 of the report, where the Trust had worked with the Sahara group to work with Black ethnic groups. He said he saw no mention of an Asian group, which he cited as being the largest ethnic group in the Wolverhampton area, and wanted to know if there were any examples the RWT could give of groups that worked specifically with Asian families.

The Director of Midwifery Royal Wolverhampton NHS Trust stated that the Equality, Diversity and Inclusion lead on their team worked with support groups that worked with all ethnicities. She said they were encouraging all ethnic groups to attend the support groups.

The Councillor wanted to know if they were able to give numbers of the uptake of Asian families or Asian women within these groups.

The Director of Midwifery Royal Wolverhampton NHS Trust replied that she did not have that data available currently but would provide it to the Councillor via email afterwards.
A Councillor stated that he appreciated the report but said it was one of the largest he had read. He wanted to know if information in the future could be condensed.

The Chair  ...  view the full minutes text for item 5.

[The Royal Wolverhampton NHS Trust to present their Quality Accounts 2022 – 2023]

The Chief Nursing Officer gave a presentation (A copy is attached to the signed minutes) and gave a brief overview of the purpose of Quality Accounts for the benefit of new Panel members. She reported that despite the issues Covid-19 had created within the service, they had managed to achieve or were making good progress on their 2022/2023 aims which were contained within priority areas which included; patient safety, clinical effectiveness, and patient experience. 2023/2024 priorities were based upon a joint Trust strategy.  The Royal Wolverhampton Trust (RWT) recognised the areas of praise and concern covered by the City of Wolverhampton Council’s (CWC) Health Scrutiny Panel statement on the RWT Quality Account and stated that they had plans in place to drive for further improvement in those areas of concern raised which were: Infection Prevention, diagnostics, cancer performance, Referral to Treatment, improvements in staff satisfaction and retention.

The Chief Nursing Officer gave an update on future 2023/2023 priorities (detailed within the presentation document). The future changes as part of Patient Safety were led by changes at the national level. For clinical effectiveness, nationally recruitment and retention of staff were a challenge but the Chief Nursing Officer said that the RWT were in a healthy position with their vacancy rates, fluctuating but averaging at 2% due to proactive recruitment. Their main challenge was retention of staff, which was a focus to improve in the future. This was primarily based on career advancement opportunities and not a negative reflection of the workplace. For patient experience, a huge project was underway to tackle inequalities within the healthcare service, the EDI team was playing a role in this; it was also multi-stakeholder.

The Chief Nursing Officer informed the Panel that they aimed to hit the national target and were on target to reduce the 62 day waiting list on cancer treatments in May 2024. They had launched a “further, faster” program to streamline patient pathways. She recognised the need for continuing improvement. They were liaising with other stakeholders to increase elective surgery. The Trust was partaking in Infection Prevention research regionally and nationally to understand some of the rises of some bacteria and they had quality improvement initiatives underway to tackle it. The Virtual Ward had been expanded and was being continually reviewed to check the patients experience and outcomes.

A Councillor referred to page 10 of the Quality Account, citing discrepancies between the 2022/23 aims and end of year goals. It was reported they aimed to create a mental health strategy, but this was not mentioned in the outcomes. The Councillor wanted to know if this meant the Trust had not developed a mental health strategy. She said that the Trust was now responsible for 7 GP practices but couldn’t understand why they were not a part of the report.

The Chief Nursing Officer stated that the GP practices would have been a part of the Quality Account process. In reference to the mental health strategy she said that as an acute provider  ...  view the full minutes text for item 6.

[Healthwatch Wolverhampton to deliver report to Panel]

The Manager of Healthwatch Wolverhampton presented the Healthwatch Wolverhampton Annual report (April 2022/2023).  She explained to the Panel that Healthwatch Wolverhampton had limited resources and a small team with which they had to deliver their service. In addition to the manager, their staff count was 3 members in size, with one vacancy. 2 positions were paid and 1 was voluntary. Across the year they had supported over 2500 people to get advice on local services, which the report detailed. The most viewed report they had done was their survey and report on improving access to GP services. They had also delivered reports on quality within care homes. The report also touched upon Healthwatch’s information and sign posting service. They had received a higher percentage of phone calls and email communications from people that year, which they felt showed their profile had been raised.

The Manager of Healthwatch Wolverhampton remarked that their social media profile had grown, with more content and more followers. Further figures from the report were covered. Healthwatch employed a partnership working approach and had worked with them to make sure patient voices were heard. They had worked with numerous boards, services within the Royal Wolverhampton Trust (RWT), charity organisations and the University of Wolverhampton. Healthwatch Wolverhampton had fed 100 articles to the national Healthwatch organisation which had informed the Government. Healthwatch Wolverhampton had provided work experience to people, with the volunteers being cited as strong working examples of that. The year ahead was continuing to look at access to GP services, with an additional focus on online. They were looking at mental health practices, with an emphasis on people with autism. They would also be looking more at care homes.

The Chair stated that the Government was removing the requirement for the NHS to monitor cancer treatment waiting times, she wanted to know in light of this, if Healthwatch Wolverhampton would be able to focus any time to monitor patient access to cancer treatments in Wolverhampton.

The Manager of Healthwatch Wolverhampton stated they would not have the capacity to do that due to their limited resources. They said they could contribute to the request if it was in supporting partners who were taking the lead, but not as a project of their own.

The Chair referred to page 19 of the Healthwatch report where it stated that Healthwatch Wolverhampton had received £1200 from the Care Quality Commission (CQC) to support the work of board member recruitment. Recently the Healthwatch board had been dissolved. She wanted to know how the funding was now going to be used.

The Manager of Healthwatch Wolverhampton said they were currently in the process of creating and forming a new Community Panel, based off positive examples in other local authorities, to replace the board. The funding would be used for this subject to consultation with the CQC to gain permission to use the funds for the new Community Panel.

A Councillor asked if Healthwatch could attend PACT meetings with the Councillors. He also  ...  view the full minutes text for item 7.

[The date of the next meeting is 14 December 2023]

The date of the next meeting was confirmed as 14 December 2023.