Agenda and minutes

Apologies for absence were received from Councillor Leach  and David Loughton, RWHT.

Councillor Malcolm declared an interest in item 7 Black Country Sustainability and Transportation Plan – the wider perspective as an NHS employee.

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

Resolved:

That, subject to the inclusion of Councillor Brackenridge’s name in the apologies for absence, the minutes of the meeting held on 25 May 2017 be confirmed as a correct record and signed by the Chair.

[To consider any matters arising from the minutes.]

Earl Piggott-Smith, Scrutiny Officer confirmed that under Matters Arising from the previous meeting, the dental information regarding tooth extractions had been forwarded to Councillor Judith Rowley.  The report on Open Spaces was still being prepared and would be included on the Panel’s work programme for a future meeting, when Planning Services have completed their work

In respect of minute 5, The Royal Wolverhampton NHS Trust Quality Account 2016/17 (Draft), Jeremy Vanes, Royal Wolverhampton Hospital NHS Trust confirmed that the information requested in resolutions 4 and 5 was available and would be circulated to the Panel.  In respect of resolution 6, he confirmed that the Hospital-Level Mortality Indicator (SHMI) should be available in the autumn for the Panel to consider.

Councillor Brackenridge referred to minute 7, West Midlands Ambulance Service (WMAS) Quality Account 2016-17 and that a draft response would be produced and shared when available.  He suggested that this was too vague and requested that in future, recommendations be more specific regarding timelines. 

Earl Piggott-Smith confirmed that in respect of the above comments from Councillor Brackenridge, an initial response had been circulated to the Panel and in future the minutes would include a more definitive response.

[Andrea Smith CCG, Head of Integrated Commissioning, WCCG and David Watts (or delegate), Director of Adult Social Care, to on the work being undertaken by CCG/RWT/BCPFT/CWC on addressing delayed transfers of care]

David Watts, Director of Adult Social Care, City of Wolverhampton Council, and Andrea Smith, Head of Integrated Commissioning, Wolverhampton CCG, presented the report on care pathways for the frail elderly and highlighted the key points.

David Watts referred to the importance of ensuring that care pathways were good in the city.  There were several different drivers for health and social care, a key document being the NHS Five Year Forward View which stated that areas should have a plan for integrating health and social care by 2020.  He referred to the Better Care Fund (BCF) Programme which was the primary way to implement change through the more efficient use of resources.  The programme was currently being refreshed and had yet to be signed off.  That delay had primarily been caused by the delay in published guidance from the Department of Health, which had become available on 4 July 2017. Once finalised, the Leader of City of Wolverhampton Council would be asked to sign it off.

He referred to several projects underway which aimed to avoid emergency admission to hospital and Delayed Transfers of Care (DTOCs) and he asked Andrea Smith, Head of Integrated Commissioning, to highlight several them.

Andrea Smith referred to the following projects:

People Living with Frailty Programme.  This was in the BCF Programme, with several work streams to support primary and secondary care.  GPs were taking part in a pilot scheme looking at patients using a Frailty Index to identify those most in need.  By using Care Management Plans, it was hoped to allow the elderly to remain at home for longer.

Review and Redesign of Community Services Programme.  This was in the BCF Programme, with all services being provided to ensure the right services in the community setting and the right support.

Admission Avoidance Programme.  This was both proactive and reactive; community nurses worked proactively with GPs to look at high risk patients and those frequently using services.  The Rapid Intervention Team worked reactively with nurse based teams in the community supported by Social Care teams.

David Watts referred to the following projects:

Discharge to Assess Programme.  As from the beginning of 2017 it had become part of the BCF Programme as it was considered that it covered the whole system.  A pilot scheme using Discharge Hubs and improved initial assessments had been introduced on four wards at the Royal Wolverhampton Trust.

• Six-month extension of Home Assisted Reablement Programme (HARP).
• Additional Stepdown/Very Sheltered Housing or Extra Care.
• Hospital Discharge Demand Management Implementation.
• Hospital Discharge Voluntary Sector Service.

The above projects were part of additional Adult Social Care.  £6.4million would be available this year if three conditions were met. Firstly, stabilising the local care sector, secondly relieving press on the NHS locally by getting more people home safely and quickly,and thirdly helping to deliver the challenges for health.  Spending was controlled by the BCF Programme Board and the A & E Delivery Board.

In response to questions from Panel  ...  view the full minutes text for item 5.

[Elizabeth Learoyd, Chief Officer, Healthwatch Wolverhampton to present

Annual Report 2016/17]

Elizabeth Learoyd, Chief Officer, Healthwatch Wolverhampton presented the Healthwatch Wolverhampton Annual Report 2016-17 and highlighted the key points.

She stated that following her appointment as Chief Officer in November 2016, the profile of the organisation had been raised to ensure that it was more visible and putting the public and patients first. 

She referred to the following highlights during the year:

• NHS Complaints Advocacy Service working with Wolverhampton Health Advocacy Complaints Service (WHACS) to provide better one to one support.
• Building engagement through community awareness campaigns.
• Development of Experience Exchange digital service to allow the public to search for and provide feedback on hundreds of health and social care service providers.
• Hospital enter and view visits where trained volunteers talked to patients and worked with providers to suggest recommendations.
• Healthwatch Advisory Board setting five priority work areas for 2017/18 based on listening tour information from over 400 people.
• Work with the University of Wolverhampton to improve access for the deaf.  A collaborative report and video would be published in October 2017.
• Project with the Urgent Care Centre.  

In response to questions from Panel members, Elizabeth Learoyd stated the following:

• When recommendations were made to the Urgent Care Centre, responses were received, the Vocare Improvement Board was invited and some of those recommendations were implemented.
• In respect of priorities and timescales for activities, delayed transfers and GP access were top of the list.  The draft document would be shared with the Board after it had been considered by the Healthwatch Board next week.
• In respect of the evaluation of the Urgent Care Centre and the characteristics of the participants, during the month’s evaluation most people who used the service were aged between 18-39 as many of them confirmed that rather than attend their GP surgery they had come straight to the centre.

Resolved:

That the report be noted.

[Steven Marshall, Director of Strategy and Transformation, Wolverhampton City Clinical Commissioning Group to present an update on the developing Black Country STP]

Steven Marshall, Director of Strategy and Transformation, Wolverhampton CCG presented an update on the developing Black Country Sustainability and Transformation Plan (STP) and highlighted key points.

He confirmed that the report had previously been presented to the Health and Wellbeing Board on 28 June 2017 and it was a review of the Government’s Five Year Forward View which had been published on 31 March 2017.  It had reiterated the need for change and how different parts of the NHS needed to work together and with partners, including local authorities.  There was a need for all hospitals to achieve a better balance in terms of accountable care and to change the way health worked.  Progress was being made with the STP, Andy Williams had been confirmed as the STP lead for the Black Country.  A draft ‘Memorandum of Understanding’ to show how health and social care would develop had been agreed in principle.  The four Clinical Commissioning Groups (CCGs) had created a Joint Commissioning Committee to lead the delivery of specialist services.

David Watts, Director of Adult and Social Care confirmed that the draft ‘Memorandum of Understanding’ would be considered by the Council’s Cabinet in September.  The other authorities’ Cabinets would also be considering the document over the summer.

Steven Marshall confirmed that the intent and design of the STP remained unchanged, with the four localities coming together.  The Transition Board had been re-designated as a Systems Development Board and it was hoped that an update would be available in early 2018.

The panel discussed plans for a new partnership between Black Country Partnership NHS Foundation Trust, Birmingham Community Healthcare NHS Trust, and Dudley and Walsall Mental Health Partnership NHS Trust. The new organisation will be created in October 2017.

The Chair suggested that Andy Williams be invited to the next meeting of the Panel.

Resolved:

That Andy Williams, the STP Lead for the Black Country, be invited to the Panel meeting when the STP was next considered.

[A summary of the key discussion points from the Health and Wellbeing Board meeting on 28.6.17 is provided for information.]

Earl Piggott-Smith, Scrutiny Officer reported to the Panel that the summary of the discussion from the last meeting of the Health and Wellbeing Board would be circulated to the Board once the Leader had agreed it.

Resolved:

That the summary of the discussion from the last meeting of the Health and Wellbeing Board be circulated to the Panel once the Leader had agreed it.

[Earl Piggott-Smith, Scrutiny Officer, to present draft work programme for comments]

The Chair referred to the successful planning event on 25 May and to the updated work programme, which would continually be reviewed.

Earl Piggott-Smith reminded members of the Panel that any councillors could ask for an item to be considered by scrutiny.  Councillor Waite had requested that the issue of Suicide Prevention be considered.

It was suggested that an additional meeting might be required when Andy Williams was invited to consider the Sustainability and Transformation Plan (STP).

Jeremy Vanes, Royal Wolverhampton Hospital NHS Trust suggested that it would be more timely to consider the issue of End of Life Care at the meeting in January 2018 rather than in September 2017.

Earl Piggott-Smith confirmed that a revised version of the Work Programme would be circulated for comment.

The Chair requested that the date of the next meeting be changed from 21 September to 28 September 2017.

Resolved:

1. That a revised version of the Work Programme, incorporating the comments and suggestions referred to above be circulated to the Panel for comment.

That the next meeting of the Panel be moved to 28 September 2017.