Agenda and minutes

Health Scrutiny Panel
Thursday, 29th March, 2018 1.30 pm

Venue: Training Room, Ground Floor, Civic Centre, St Peter's Square, Wolverhampton WV1 1SH

Contact: Earl Piggott-Smith  Tel: 01902 551251 or Email: earl.piggott-smith@wolverhampton.gov.uk

Items
No. Item

1.

Apologies

Minutes:

Apologies for absence were received from the following:

 

Cllr Hazel Malcolm

Cllr Pat Patten

Elizabeth Learoyd

Shelia Gill

Dana Tooby

Dr Helen Hibbs

Cllr Phil Page

Lesley Writtle

2.

Declarations of Interest

Minutes:

Cllr Martin Waite declared an interest in respect of agenda items five and seven.

 

3.

Minutes of previous meeting pdf icon PDF 88 KB

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

 

Minutes:

Corrections:

 

6.Oral Health Needs of Older People

 

David Watts explained that during the discussion about the oral health there was a mistake in minutes – there was no separate health survey published by the CQC that could be shared with the panel. The panel agreed to amend the minutes.

 

9. Patient Mortality Rates

 

Dr Odum commented on an error in the minutes. The panel agreed to the following change which has been highlighted in bold.

 

Dr Odum explained that Wolverhampton traditionally had a Standardised Mortality Rate(SMR) of 100 –  however this figure has increased to 115 since the opening of the new emergency department which may explain why there have been more deaths than expected. The death rate figure is based the count of adults over the age of 18 years. The hospital has the lowest expected death rate in the West Midlands region.

 

Cllr Martin Waite asked for the reference to his comments on this agenda item to be corrected. The query was whether the opening of accident and emergency centre had led to more people with more serious or complicated health problems being admitted to hospital, which had resulted in a higher than expected death rates.

4.

Matters Arising

[To consider any matters arising from the minutes.]

 

Minutes:

9. Patient Mortality Rates

 

Dr Jonathan Odum agreed to present an update report to the panel in October 2018. 

 

David Watts agreed to present an evaluation report on the impact of the Red Bag Scheme to a future meeting of the panel.

 

 

5.

Winter Planning 2017/18 - Update Report pdf icon PDF 871 KB

[Joint update report on effectiveness of actions taken by WCCG, CWC and RWHT to support local systems to prepare for and deliver resilient performance through winter 2017/18.]

Additional documents:

Minutes:

Cllr Jaspal welcomed Cllr Johnny McMahon, Chair of Healthy Staffordshire Select Committee, who accepted an invitation to attend the meeting to contribute to the discussion on effectiveness of plans for winter pressures.

 

David Watts, Director of Adult Services, gave a brief introduction to the report on winter planning preparedness from the Council viewpoint and commented on the work done with RWHT to reduce the number delayed transfers of care. The Director of Adult Services commented on the table in paragraph 3.5 which compares the performance of Wolverhampton against a number of different measures.

 

Dr Jonathan Odum, Medical Director, The Royal Wolverhampton NHS Trust, gave an overview of the work of done to manage the pressures during winter period at a time of great pressure on the NHS and social care sector. The Medical Director commented that while there was a peak in demand on the service in during November and January there was an improvement in the reducing delays of care as a result of previous planning and work with key organisations to manage the increase in patient numbers.

 

The Medical Director commented that based on published national data for delayed transfers of care, Wolverhampton performance had placed it 52nd out of the 151 local authority areas in England reporting delays in the month of January 2018. The Medical Director advised the panel that he chairs the delivery board responsible for preparing the winter plan. The Medical Director commented on challenges facing the hospital in managing the large cohort of frail elderly with complex health and social care needs and the difficulty in finding alternative suitable accommodation, where patients are considered to be ready for discharge. The Medical Director commented on the work done to learn from current experience and then use this information to review the effectiveness of the winter planning preparedness for 2018/19.

 

David Loughton, Chief Executive, RWHT, praised the performance of the hospital in planning for the increased demand during the winter period.

 

The Chief Executive, RWHT, while welcoming the extra £2 million funding to fund social care and the opportunity to bid for a share of £350 million fund from the NHS. However, there was a need for secure long-term funding to enable health and social services to better cope with the demands during period when demand increase significantly. The Chief Executive praised the support of the coroner’s office to help manage increased number of deaths during the winter period when the hospital facilities were at full capacity.

 

The panel queried if the hospital were planning to provide extra resources to support the work the Rapid Intervention Team.  The Chief Executive advised the panel that an extra £900,000 would be provided by the hospital to increase the capacity and resources of the team.

 

The panel queried if the hospital as part of its winter planning preparation work looked outside the health sector to learn how other organisations manager increased demand during the winter period.

The David Loughton, Chief Executive, RWHT, commented that a meeting  ...  view the full minutes text for item 5.

6.

Urgent and Emergency Care 7 day Services pdf icon PDF 321 KB

[Dr Jonathan Odum, Medical Director, RWHT, to present report]

Minutes:

Dr Jonathan Odum, Medical Director, The Royal Wolverhampton NHS Trust, gave an overview of the report detailing progress towards the delivery of a seven-day care provision to patients admitted to the hospital as either an emergency or urgent case.

 

The Medical Director explained that the seven-day provision is aimed at offering equability of patient care at the weekend and all acute trusts are expected to meet 10 national standards by 2020 as detailed in the report.

 

The Medical Director advised the panel of the background to the policy and how it links to others plans aimed at providing access to clinical services throughout a patient’s stay in an acute hospital bed.

 

The Medical Director advised the panel that RWHT was on one of the early adopters and is committed to achieving the four priority standards detailed in para 2.8 of the report.

 

The Medical Director advised the panel that RWHT was meeting the 90% targets for each of the standards and see it as a quality mark for the service.

 

The Medical Director advised the panel of the benefits to the hospital of having access to consultants who can assess and discharge patients where appropriate. The Medical Director commented on the challenges nationally to delivering seven-day service, for example, the availability of services such as hospital social work teams who are not available at the weekend.

 

The panel discussed the findings detailed in the table in para 2.18   which gave a summary of progress against the six other national standards.

 

David Watts, Director of Adult Services, commented on the challenges to achieving the stated aims and need for further discussions about how they can be delivered – for example, the costs involved of having a senior social worker to assess and accept patients and whether the council or home should fund the extra costs to provide standby cover at the weekend. The Chief Executive commented on the workforce shortages across the sector and national challenge hospitals face in recruiting nursing and specialist staff needed to deliver a safe and efficient service, in addition to finding the extra consultants needed.

 

The panel discussed the impact of weekend discharge on the hospital as part of seven-day service had on the workload for consultants and other services on Monday. The Medical Director commented that the analysis of results suggests that the introduction on seven-day care services had not led to expected benefits such as reduced workload on Monday’s for staff.

 

The Medical Director commented that the evidence supporting the benefits of offering seven-day care for people admitted for emergency or urgent care is not convincing and that further investigation is needed to better understand the links between the factors that determine patient outcomes. This may involve analysis of patient mortality notes.

The panel agreed to receive an update on performance against the six standards detailed in para 2.18 of the report.

 

The panel thanked Dr Odum for the presentation.

 

Resolved: Dr Jonathan Odum, Medical Director, RWHT< to present a report of progress  ...  view the full minutes text for item 6.

7.

Update on the work of the suicide prevention stakeholder forum pdf icon PDF 94 KB

[Neeraj Malhotra,Consultant in Public Health, to present report]

 

Minutes:

Neeraj Malhotra, Consultant in Public Health, introduced the report on the work of the suicide prevention stakeholder forum and invited panel members to comment on progress. The Consultant in Public Health commented on the desire to have more regular attendance by a representative of the RWHT at meetings of the forum. The Chief Executive agreed to have a discussion with Consultant in Public Health about the involvement of the hospital in work of the forum.

 

The Consultant in Public Health commented that the forum is making good progress against the targets in the suicide prevention stakeholder forum action plan and will be reporting to a future meeting of Health Wellbeing Board.

 

The Consultant in Public Health commented on the positive work by West Midlands Combined Authority in developing Thrive West Midlands which details plans for implementing recommendations from the mental health commission and this includes work to reduce the level of suicides.

 

The Consultant in Public Health gave an overview of the suicide trends in Wolverhampton since 2002 and progress against the suicide prevention strategy and action plan. The Consultant in Public Health gave examples of the work being done to both promote good mental health among the whole population but also provide specialist support to people considered to be most at risk of suicide. The Consultant in Public Health commented on the importance of training for professionals and lay people to be equipped to have conversations with people who are feeling suicidal and listen and when to signpost the person to another agency.  She made specific referenced to the zero suicide alliance e-learning on suicide prevention and will circulate the link to panel members.

 

The panel discussed the impact of media reporting of suicides. The Consultant in Public Health commented on the work of Samaritans to deliver training to help journalists prepare reports and the level of detail they should include about the cause and circumstances of death.

 

The panel discussed the role of GPs in identifying and supporting people. If resources can be identified, this is to be picked up and delivered in partnership with the CCG and needs to be offered to the broader primary care workforce including care navigators and social prescribers.  Public Health to pick this up with the CCG.

 

The review group discussed the profile of suicides by gender and age. The Consultant in Public Health advised the panel the issue of suicides in middle-aged men will be on the agenda of the next meeting of group. The Consultant in Public Health commented on the plans to get more real-time date from the coroner’s office about suicides - this work needs to be done across the Black Country Region.

 

The panel discussed research findings which highlighted evidence that some sections of the community were more vulnerable to poor mental health and risk of suicide. The panel discussed the issue of whether specific job occupations were more vulnerable and growing awareness in services of the need to offer work placed counselling.

 

The Consultant in Public  ...  view the full minutes text for item 7.

8.

Public Health Transformation Public Consultation pdf icon PDF 103 KB

[John Denley, Director of Public Health, to present report]

Additional documents:

Minutes:

John Denley, Director of Public Health, introduced a presentation on the findings of the public consultation about proposed changes to the priorities of the service. The Director of Public Health advised the panel that 1200 responses were received and were a good demographic representation of the population. 

 

The Director of Public Health gave a summary of the main findings from the public consultation and response from the service. The Director of Public Health commented on the importance of working with partner organisations to deliver public health changes that support the new priorities for the service.

 

The Director of Public Health commented that Public Health annual report would be presented to a future meeting of the panel and that work would be done to meet targets of the national framework.

 

Resolved:

            The panel agreed to receive a further progress report on the vision of public health service in the future and against national indicators to a future meeting in 12 months.