Agenda and minutes

Health Scrutiny Panel
Thursday, 20th September, 2018 1.30 pm

Venue: Committee Room 3 - Civic Centre, St Peter's Square, Wolverhampton WV1 1SH

Contact: Martin Stevens  Tel: 01902 550947 or Email: martin.stevens@wolverhampton.gov.uk

Items
No. Item

1.

Apologies

Minutes:

An apology for absence was received from Cllr Milkinder Jaspal.

2.

Declarations of Interest

Minutes:

There were no declarations of interest. 

3.

Minutes of previous meeting pdf icon PDF 88 KB

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

 

Minutes:

The minutes of the previous meeting were approved as a correct record, subject to Tracey Creswell’s job title being amended to, “Local Healthwatch Manager,” and the correction of the spelling of “Sheila Gill’s” first name listed under apologies. 

4.

Matters Arising

[To consider any matters arising from the minutes.]

 

Minutes:

The Chair made reference to the two Special Health Scrutiny meetings taking place in the following month.  The one on the 23 October was regarding mortality rates at the Royal Wolverhampton Health Trust, the second on the 25 October was regarding the death certification processes.   Both meetings would be taking place at the Civic Centre.

 

The Chair asked for an update on the car parking at New Cross Hospital.  The Chief Executive of the Royal Wolverhampton Health Trust responded that they were building an extra 600 car park spaces at New Cross Hospital.  He was however transferring a significant number of staff from Walsall, Dudley and City Sandwell.  The likely number to be transferred was in the region of 550 staff.  One of the car parks was nearly completed, when this car park was finished, work would commence on the multi-storey.  During the construction of the multi-storey car park, at the front of the site, 250 car park spaces would be lost for a period of 19 weeks.  The Vice Chair asked for a timetable of the car park works to be circulated.  The Chief Executive of the Royal Wolverhampton Health Trust agreed to submit the timetable to be circulated with the minutes.  

 

The Chair of Wolverhampton Healthwatch asked for assurances that due diligence had been undertaken by the Royal Wolverhampton NHS Trust Board on the outsourcing of the New Cross Hospital carpark and security.  She agreed to send her questions direct to the Chief Executive of the Royal Wolverhampton Health Trust. 

 

The Chair of the Scrutiny Panel asked for an update on the old eye infirmary building at the Compton Road Site.  The Chief Executive responded that City of Wolverhampton Council had listed the building eleven years ago, which had prevented him from selling the site.  It was in the gift of the Council to remove the listing.  Modern house builders did not want to take on a listed building due to the associated conversion costs.  There had been significant deterioration to the building in the last eleven years, making conversion even less attractive to developers.  He agreed to complete a short briefing note on the site and added that they were in sight of selling the site. 

 

 

 

 

5.

Urgent and Emergency Care - 7 Day Services - Update pdf icon PDF 130 KB

[Dr Jonathan Odum, Medical Director, Royal Wolverhampton Health Trust to present report]

Minutes:

Dr Jonathan Odum, Medical Director – The Royal Wolverhampton Trust, presented a report on the Urgent and Emergency Care Seven Day Services.  The seven day service delivery had been an aspiration of Government for some time.  It had been a challenge across the country to implement the Government’s aspirations.  It was important to be clear that it was not about delivering elective, non-emergency care.  There were four priorities out of the ten that had been set out by NHS Services.  Those being: -

 

a)    All patients admitted as an emergency to be reviewed by an appropriate consultant within 14 hours of admission.

 

b)    All patients to be reviewed daily via a consultant delivered ward round.

 

c)     Seven day access to consultant directed and reported diagnostics.

 

d)    Twenty-four hour access to consultant directed interventions e.g. endoscopy and emergency surgery.

 

The Medical Director stated the monitoring of the seven day service was done centrally through a tool kit. The results of the monitoring for the last three years were listed in the report. The first standard, the assessment by an appropriate consultant within 14 hours of admission, the Trust had consistently achieved the pass standard over the last two years.  The daily consultant review standard for last year was at 95%.  The Trust was slightly below this figure for 2018, this was down in part to the selection of the case records and some outstanding consultant appointments in the care for the elderly. 

 

The Medical Director stated that in relation to accessibility to diagnostics and early interventions, the Trust had always been fortunate to have seven days a week full access and thus achieved a consistent pass rate.  The area which the Trust was making inroads was in relation to the patient daily review.  Nationally there was a shortage for care of the elderly consultants, but he was pleased to report that the Trust had recently appointed two more consultants in this specialism.  The other area where there had not been a full complement of consultants was in neurological services, this was however to be re-established in the near future. 

 

The Medical Director stated that the reporting mechanism was due to change.  Reporting mechanisms would in future be via Trust Boards and the CCG Improvement and Assessment Framework.  The data which the Trust had gathered showed the changes to service delivery had positively benefited the care of patients attending for emergency care at RWT.  The feedback from patients and their relatives had been positive about the opportunity for consultants to see them at weekends.  The availability of consultants at the weekend had led to timely interventions in patient care, which in the past would have waited until the following Monday.  There were ongoing developments about a move to 7 day services in primary care. 

 

The Medical Director highlighted that the Trust faced some challenges with the transfer of mental health patients to community sites at weekends.  Overall the Trust was in a good position. 

 

The Chair of the Healthwatch Advisory Board commented  ...  view the full minutes text for item 5.

6.

Black Country Sustainability and Transformation Plan - Update pdf icon PDF 174 KB

[Dr Helen Hibbs, Senior Responsible Officer for the Black Country and West Birmingham Sustainability and Transformation Partnership (STP) to present report]

Additional documents:

Minutes:

Dr Helen Hibbs, the Chief Officer for Wolverhampton CCG / Black Country STP Senior Responsible Officer gave a presentation on the Black Country Sustainability and Transformation Plan, a copy of which is attached to the signed minutes.  The presentation outlined the STP progress to date.  It also detailed the initial work around the Black Country Clinical Strategy, key areas of integrated working between health and social care, and the ongoing development of primary care.  It also highlighted some of the main challenges, risks and drivers for delivering integrated care in the future. 

 

The Chief Officer for Wolverhampton CCG / Black Country STP Senior Responsible Officer stated that the Clinical Strategy would make a difference to local patients by reducing unwarranted variation and duplication across health and care services.  It would also help to improve people’s health, improve the quality of services and deliver financial stability.  The strategy had 12 priority areas.  The current areas of focus were cancer, mental health, learning disability services, maternity and neonates and primary care.  Over the next few months they would be engaging local clinicians and communicating with patients and the public before launching the strategy in November 2018.  Integrated work with Adult Social Care was a component of the STP Plan. 

 

The Chief Officer for Wolverhampton CCG / Black Country STP Senior Responsible Officer remarked that primary care was at the heart of the place based plans and was integral to delivering improved health and wellbeing.  There were some challenges and risks which she highlighted as follows: -

 

·       Collaboration across the 18 partner organisations

·       Unwarranted clinical variation

·       Recruitment and retention of clinical workforce

·       Financial sustainability

·       Development of population health management

·       Digital innovation

·       Primary and community care estates

·       Wider determinants of health

 

She stated that the STP would work collaboratively with its health and care partners to move towards an Integrated Care System (ICS). 

 

The Chief Executive of the RWHT stated there was now agreement to merge pathology Services across the Black Country, Sandwell and West Birmingham.  On the 1 October he would inherit 21 Consultant vacancies in Pathology and he estimated it would take at least two years to recruit to them.  Russells Hall only had one Consultant in post, when their establishment was 6.5 posts.  He did not want the manpower situation to worsen in other services.  The work force problem was a serious issue across health organisations in the Black Country, which became a problem for the RWHT when they had to take on responsibility for services, such as pathology.  He was also concerned about the financial position of neighbouring Trusts and the wider national finances of the NHS. 

 

The Chief Executive of the RWHT stated that there was a large amount of issues taking place near to the Wolverhampton border which would impact the RWHT.  At a meeting in Dudley in the previous week the CQC had wanted to close an A&E Department at nights and at weekends.  This had been prevented.  On the 27 September, the Board at Shrewsbury  ...  view the full minutes text for item 6.

7.

Transforming Care Plans (TCP) for adults, children and young people with Learning Disabilities and/or Autism across the Black Country pdf icon PDF 58 KB

[To receive a report and presentation on Transforming Care Plans (TCP) for adults, children and young people with Learning Disabilies and/or Autism across the Black Country]. 

Additional documents:

Minutes:

A presentation was given on the Transforming Care Plan (TCP) for adults, children and young people with learning disabilities and/or autism across the Black Country. A copy of which is attached to the signed minutes.  

 

In summary, Dr Helen Hibbs, the Chief Officer for Wolverhampton CCG and Senior Responsible Officer of the STP stated in April 2016 the Black Country CCG’s and Local Authorities had formed a partnership to transform care for people with learning disabilities and/or autism.  The programme aimed to reduce the number of people with learning disabilities and/or autism residing in hospital so that more people could live in the community, with the right support, near to their home.   A board had been established to ensure the success of the programme.  The BBC Panorama programme in 2011 had exposed the abuse of young people with learning disabilities at Winterbourne View Hospital and ultimately led to the closure of the hospital.  NHS England had decided something radical needed to be done to transform care in the specialism.  The Black Country TCP was now working with people with learning disabilities and autism, their families and carers to agree and deliver local plans for the programme. 

 

Dr Helen Hibbs, the Chief Officer for Wolverhampton CCG and Senior Responsible Officer of the STP remarked that using the nine principles from the National Service Model and guidance from NHS England, the TCP had developed a new clinical model for learning disabilities in the Black Country.  The National Transforming Care Programme mandated that each TCP met the nationally prescribed trajectory for bed reduction by March 2019.  For the Black Country this meant reducing CCG commissioned beds from 41 to 16. 

 

A Member of the Panel referred to an individual who had autism who had been struggling to find work since leaving sixth form college.  He found it difficult to engage customers in the jobs he had taken and thus was not kept on long-term.  He had not been deemed eligible for PIP (Personal Independence Payment) by the Department for Work and Pensions.  He was therefore really struggling to find an income because of his autism.  In response the Chief Officer for Wolverhampton CCG and Senior Responsible Officer stated that they were looking at the autism pathway and she was happy to provide some more information to the Councillor.  It was important that people with autism were given a care worker to help them maintain employment.  She added that relationships with the Department for Work and Pensions were also important.  The Director for Adult Education commented that the Council encouraged people to challenge PIP assessments.  The Council also had a number of initiatives to support people into work including job coaches. 

 

The Chair of Healthwatch asked for a future agenda item to be on the role of the third sector in supporting people into work who had specific health conditions.  She was also aware of a nine-year-old child with autism, whose parent was having difficulties with a referral request.  She offered to send the  ...  view the full minutes text for item 7.

8.

Joint Public Mental Health & Wellbeing Strategy pdf icon PDF 114 KB

[Lina Martino, City of Wolverhampton Council and Sarah Fellows, Wolverhampton Clinical Commissioning Group, to present briefing]

 

Additional documents:

Minutes:

The Public Health Consultant presented a report on the Joint Public Mental Health and Wellbeing Strategy.  She commented that Government Strategy called for mental health to be given equal importance to physical health, referred to as parity of esteem.   It was important to focus not just on helping people with mental health difficulties but also on prevention.  The Joint Public Mental Health & Wellbeing Strategy provided a high-level summary of current and planned workstreams across the Council and CCG to promote population wellbeing and improve mental health.  The aim was to not only meet the specific needs of different age groups, but also to reduce cumulative disadvantage associated with poor mental health and wellbeing and related risk factors.  She referred to the table on page 16 and 17 in the report which illustrated how complicated the mental health system was to navigate. 

 

A Councillor referred to a gentleman who had attended a six-week mental health course, had shown improvement whilst on the course, but had now relapsed.  He was awaiting further treatment.  This highlighted the gaps in between stages and cited ongoing wider community support as being important in such cases. 

 

Resolved: That the Health Scrutiny Panel note:-

 

1)    The Joint Public Mental Health & Wellbeing Strategy is an overarching document that incorporates City of Wolverhampton Council (CWC) and NHS Wolverhampton CCG’s Joint Mental Health Commissioning Strategy for 2018-2019–2020-2021. It includes not just commissioned services to support people with mental health problems, but wider public services and workstreams to prevent mental ill health and promote population wellbeing.

 

2)    The Joint Public Mental Health & Wellbeing Strategy and Joint Mental Health Commissioning Strategy were informed by an extensive consultation that was carried out as part of a Mental Wellbeing Needs Assessment completed in June 2017. This included:

 

a)    The Wolverhampton Healthy Lifestyle Survey conducted in March 2016, which included specific questions related to mental wellbeing and elicited responses from 9,048 individuals across the city;

 

b)     24 focus groups with the community such as younger adults, older working age adults, and older people; and

 

c) 34 interviews with professional stakeholders including voluntary sector representatives, health professionals such as GPs and Pharmacists, and Council officers from a variety of teams.

 

3)    Initial feedback was sought on the draft Strategy document from Council and NHS professionals, and members of the Wolverhampton Mental Health Stakeholder Forum and Suicide Prevention Forum. A process of further engagement is currently underway to capture feedback from a broader range of stakeholders.

9.

Mental Health Commissioning Review Update on Recommendations pdf icon PDF 157 KB

[To receive an update on the recommendations from the Mental Health Commissioning Review]. 

Minutes:

The Director for Public Health introduced an update report on the responses to the recommendations of the 2017-2018 Mental Health Scrutiny Review.  The Chair complimented Officers on the excellent collaborative work to date on the recommendations from the initial review. 

 

Resolved: To note the update on the response recommendations to the Mental Health Scrutiny Review.  

 

10.

Joint Health and Wellbeing Strategy 2018-2023 pdf icon PDF 76 KB

[To receive the draft, Joint Health and Wellbeing Strategy 2018-2023]

 

Additional documents:

Minutes:

The Director for Public Health introduced a report on the Joint Health and Wellbeing Strategy 2018-2023.

 

The Consultant in Public Health commented that a consultation had been launched.  269 responses had been received to date with an 87% completion rate. 

 

The Healthwatch Chair asked about the duration of the consultation process on the strategy.  The consultant in Public Health responded that that it had opened on the 5 September 2018 and would close on 28 October 2018.  The findings of the consultation would be released in December. 

 

A Member of the Panel asked that the Council do its best to engage the third sector.  The Director of Public Health agreed it was important to engage the third sector which was being involved.  He asked for any specific suggestions of groups to be emailed directly to him so they could be included as part of the consultation process. 

 

Resolved: That the Scrutiny Panel supports the Health and Wellbeing Board’s approach to the Joint Health and Wellbeing Strategy. 

11.

Work Programme pdf icon PDF 72 KB

[To discuss the Work Programme of the Health Scrutiny Panel]. 

Minutes:

Resolved: That the work programme be approved.

 

The meeting closed at 3:30pm.