Agenda and minutes

Apologies were submitted on behalf of Cllr Judith Rowley and  Cllr Arun Photay

Cllr Martin Waite declared a disclosable pecuniary interest as an employee of the West Midlands Ambulance Service

To approve the minutes of the previous meetings as a correct record, as follows:

7.4.2016

28.4.2016

Resolved

That the minutes of the meeting be approved as a correct record subject to Don McIntosh being added to the attendance list.

[To consider any matters arising from the minutes.]

Resolved

That an update report relating to the progress made in the implementation of the Joint Mental Health strategy be reported to the next meeting of the Health Scrutiny Panel.

Attached is the draft of the Quality Account document in full for you to review and provide comment.

Jeremy Vanes Chair of Royal Wolverhampton NHS Trust (RWT) and David Loughton Chief Executive of RWT provided the draft Quality Account . He advised that there had been changes to the report since publication of the draft version and that it was an evolving document. He highlighted the priorities around safe nurse staffing levels, safe care and the sign up to the safety issues such as sepsis, preventing infection and patient experience. He invited the panel to comment and provide a statement from this panel to be included in the document when published on 30 June 2016.

The Chair Cllr Jasbir Jaspal advised that a draft statement was in preparation and any comments of the panel would be included in the response statement.

In response to points raised the Chief Executive RWT confirmed that there were currently 230 vacancies which were approximately nine per cent of total nurse staffing. He clarified that there was some evidence to indicate that the shortage is impacting on the service provided but that this issue was not unique to Wolverhampton and that it was a national problem. He indicated that recruiting nurses from outside of the EU was a slow process out of 220 nurse posts offered to Philippine applicants earlier in the year only six visa’s had been secured, he suggested that when competing with Canada and the USA for nursing applicants the visa process needs to be more efficient.  He highlighted that a big problem for recruiting nurses in the NHS moving forward was the removal of a bursary for student nurses, meaning that student nurses now would have to apply for a student loan. The full impact on the numbers of trainee nurses due to the bursary being removed would not be known until August 2016. 

In response to questions from Cllr Wendy Thompson relating to the bursary scheme, medical training and recruitment, the Chief Executive advised that approximately half of trainees complete the training and that Doctors are recruited from overseas on the basis that they carry out both clinical and academic training.  The recruitment on the basis responds to the need for staff and reduces the use of interims or agency staff.

Helen Hibbs, CCG responded to further questions about why more universities do not establish specialist training facilities highlighting that there was a high dropout rate.  The Chief Executive RWT advised that the has previously been on the Government Advisory Board and although it is preferable that the number of medical schools are increased it would be a ten to twelve year journey and that in his opinion it was unlikely that there would be an expansion of medical schools in the UK in the short term, there may however be more spaces created at existing facilities. He clarified that RWT were in final discussion with the armed services about Accident and Emergency services. (A&E).

Cllr Peter O’Neill welcomed the style of the document, well put together, open and transparent.  He particularly  ...  view the full minutes text for item 5.

Verbal update on the progress made to address actions from the CQC Inspection plan.

Jeremy Vanes, The Chair of Royal Wolverhampton NHS Trust (RWT) provided a verbal update to the Panel. He advised that following the CQC inspection, where 70 inspectors had been present for a whole week, 145 actions had been identified. He advised that all but 11 small scale actions had been completed and that many of the actions had been consumed into other action plans.

The Chair advised that the first round of inspections had been on a large scale and that the process has since been revised, the CQC will have a smaller inspection regime with a different style of report.

Resolved

1. That the update be noted.

To include some background on the level of alcohol related emergency admissions as requested by Scrutiny Board.

Jeremy Vanes, the Chair of Royal Wolverhampton NHS Trust (RWT) gave a verbal update relating to the Accident and Emergency (A&E) Department. He advised that there are more than average referrals in the drugs and alcohol referral scheme last year (648).  Ros Jervis, Service Director Health and Well Being, explained that the Community Drugs and Alcohol Team have a good relationship with the clinicians and help people to seek support and that this can be a motivation to change due to the teachable moment (event). Panel were advised that there were also patients who do not want to change, revolving doors patients but that there seem to be reducing numbers of them and Panel were encouraged to hear that the mortality level was also falling.

Panel considered that there were several groups of people on the journey of dangerous drinking levels for a variety of reasons (including binge drinkers and young people).  They recognised that prevention and early intervention work and that this was an uphill battle to reduce the impact of drinking.  The Service Director advised that the business community in the City Centre now pay for the services.

In response to questions The Chief Executive RWT advised that the Police work hand in glove with RWT and multiagency services but that the RWT cannot breach Patient confidentiality.  The Chair RWT responded to questions from Cllr Martin Waite relating to proportion of patients that attend on the weekends, the ageing population and Stafford ambulance crews bringing them into Wolverhampton during the night. The Chief Executive confirmed that patients under the influence of drink or drugs are in a separate section from other patients he advised that these issues were part of system reform. He acknowledged that as an employer of 9000 staff there was a need to help staff with specific alcohol problems.

In response to Cllr Patricia Patten’s questions about levels of teenage drinking the Service Director advised that the highest affected group was males aged 35-45 and that there were not large numbers of young drinkers. It was clarified that the highest number of chronic drinking and liver related illnesses tend to be in middle aged males.

Helen Hibbs, CCG highlighted the number of elderly and frail people admitted to hospitals and explained there are other ways of caring and that it was not all about going into hospital.

The Chair RWT gave an update relating to the Urgent Care Centre which had opened in April 2016. He advised that there had been several developments including the recruitment of nurses, who were waiting to start.  He outlined the success of the joint triage and the benefits of having a senior Doctors diagnosis earlier in the process.  He advised that admission rates were down 15% as a result of this.  In terms of performance he advised that the A&E unit had recently demonstrated the 24^th best performance in the Country.

Resolved

1. Panel welcomed the outstanding performance and noted the update  ...  view the full minutes text for item 7.

The purpose of this report is to advise members with regards to the progress of the Wolverhampton Primary Care Strategy and its implementation.

Stephen Marshall CCG and Helen Hibbs CCG provided a report to update the Panel on the progress of the Primary Care Strategy Implementation. Helen Hibbs outlined the work force development initiatives taking place to address the work force crisis.  She advised that CCG were jointly commissioning GP practices proving primary care with NHS England and aim to be fully delegated to commission primary care services from general practice from April 2017.

Panel voiced concerns relating to the numbers of General Practitioners (GPs), highlighting that there were not enough GPs. Helen Hibbs responded that the GP profession had become an unattractive career prospect, that the pressure was unbelievable, administration backing up systems and so forth.  She advised where there was a large practice with a central administration facility it made a big difference to the practitioners.

Cllr Stephen Simkins asked whether Cabinet Members sat on the Governing body for the CCG and was advised that the Cabinet Member was a member of the Health and Wellbeing Board. He requested officers to investigate allocation of a seat on both Boards for the relevant Cabinet Member.

Resolved

1.         That Panel note the progress update

To follow

Jeremy Vanes, Chair RWT provided a verbal update he advised the Panel that the RWT receives educational funding for health professionals via an annual education contract with health Education England West Midlands (HEWM).

This contract is called the Learning and Development Agreement (LDA)

The contract is renewed annually dependent on performance against student and trainee numbers, and national professional educational quality standards.

The LDA for the Trust equates to circa £14 million, this is ring fenced for educational purposes soley.  For medical staff this equates to circa £12.8 million, for nursing and other health professional staff this equates to £1.2 million.

Quarterly performance reporting is mandatory against the contract value and this framework supports further financial payments for each quarter.

Resolved

That Panel note the information provided.