Agenda and minutes

Health Scrutiny Panel
Thursday, 24th January, 2019 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

[To receive any apologies for absence]. 

Minutes:

Apologies for absence were received from Tracey Cresswell (Healthwatch) and Dana Tooby (Healthwatch). 

2.

Declarations of Interest

Minutes:

There were no declarations of interest. 

3.

Minutes of Meetings pdf icon PDF 126 KB

To approve the minutes of the following Health Scrutiny Panel Meetings: -

 

Special Health Scrutiny Panel – 23 October 2018

Special Health Scrutiny Panel – 25 October 2018

Health Scrutiny Panel – 15 November 2018

Additional documents:

Minutes:

The minutes of the meeting held on 23 October 2018 were confirmed as a correct record.

 

The minutes of the meeting held on 25 October 2018 were confirmed as a correct record.

 

The minutes of the meeting held on 15 November 2018 were confirmed as a correct record.  

4.

Matters Arising

[To consider any matters arising from the minutes.]

 

Minutes:

A Member of the Panel asked for some timescales to be circulated by email in due course, in reference to the recommendations from the Special meeting held on the processes to be followed after death. 

 

A Member of the Panel asked for the current status of the Medical Examiner Role.  The Chief Executive of the Royal Wolverhampton NHS Trust confirmed that seven members of staff had been appointed and he was considering appointing an eighth. 

 

A Member of the Panel asked the Chief Executive of the Royal Wolverhampton NHS Trust, if a timetable was available for the construction of the new car park at New Cross Hospital.  The Chief Executive responded that he was unable to provide a timetable at the current time, funding for the contractor lined up to commence in April had yet to be finalised.  He commented that car parking was the worst part of the patient experience at Newcross Hospital. 

 

5.

Cancer Treatment Services

[To receive a report from the RWHT on Cancer Treatment Services].

 

[Report is marked: To Follow]. 

Minutes:

The Chief Executive of the Royal Wolverhampton NHS Trust gave a verbal report on cancer treatment services at the Trust.  He stated that the Trust had very significant problems.  They used to have 1300 referrals for cancer a month but were now averaging 1800.  They had received 600 referrals in the last ten days.  He did not understand why there had been a sudden increase in the number, but he had people working on trying to analyse why.  A rise in referrals normally correlated with a TV soap storyline but he was not aware of a cancer related storyline at the current time.  The last ten days had probably put the Trust two months behind on the plan they had to recover their position.  There had been a significant increase in the DNA (Did Not Attend) rate in the run up to Christmas and the DNA rate between Christmas and the New Year was substantial.  His team were working extremely hard but could not deal with the volume of work. 

 

The Chief Executive of the Royal Wolverhampton NHS Trust commented there were a lot of people electing to come to Wolverhampton to have robotic surgery.  In his position as Chair of the West Midlands Cancer Alliance, he wanted to ensure the Queen Elizabeth Hospital Birmingham (QE) fully utilised their robot.  Coventry and Stoke were using their robot at full capacity.  There needed to be an overall strategy for robotic surgery, as there was no national strategy in place. 

 

The Chief Executive of the Royal Wolverhampton NHS Trust stated the Trust was not equipped to be able to deal with the current volume of cancer referrals.  They had four mobile scanners on site because the fixed MRI (Magnetic Resonance Imaging) and CT (Computerised Tomography) scanners were being used to capacity.   He was also utilising the capacity at the Nuffield but was still having to use two mobile MRI scanners and two mobile CT scanners.  For patients having to use the mobile scanners, it was not a pleasant experience because they had to be pushed on a trolley across the car park in all weather conditions.  The Trust was going to have to invest in at least another two MRI scanners and two CT scanners, but he did not have the capital. 

 

The Chief Executive of the Royal Wolverhampton NHS Trust stated that they had been visited by the National Medical Director of NHSI (National Health Service Improvement) who concluded that they had a major capacity problem.  In addition, they had a significant problem with the centres who referred into the Trust, who were referring in late and with incomplete information.  NHS Improvement had said they would assist with this problem, as the Trust had no jurisdiction over the centres.  The Trust had outsourced significant amounts of endoscopy work.  Whilst the Trust had an endoscopy room at Cannock Chase Hospital, he did not have the finances available to equip the facility. 

 

The Chief Executive of the Royal Wolverhampton NHS Trust commented that  ...  view the full minutes text for item 5.

6.

Patient Advice and Liaison Service pdf icon PDF 259 KB

[To receive a report from the RWHT on the Patient Advice and Liaison Service].

 

[Alison Dowling - Head of Patient Experience and Public Involvement to present report].

Minutes:

The Head of Patient Experience and Public Involvement at the Royal Wolverhampton NHS Trust presented a report on the Patient Advice and Liaison Service (PALS).  The team had undergone a restructure in September 2017.  The Trust’s policy set the complaints completion to be within thirty working days, beyond that timeframe they had the ability to negotiate with the complainant for an extension.  A considerable amount of work on the compliance rate had taken place at the Trust over the last three years, which used to stand at 63% but for almost the whole of the financial year now stood at 100%.  All complaints that were received by the Trust were now triaged by the central complaints team.  The volume of complaints stood at almost the same as the previous six months. There had been 205 complaints compared to the previous six months of 203.  They reported to NHS Digital on a quarterly basis on how they were performing on their complaint outcomes.  The national average for complaints upheld on NHS Digital stood at 33.6%, the Trust upheld rate was considerably lower. 

 

The Head of Patient Experience and Public Involvement commented that they had introduced a new telephony system which had greatly assisted in the resolution of complaints.  PALS Concerns had steadily reduced over the last two years and the first six months of 2018 had indicated a reduction in volume of 40% from a six-monthly average of 928 (July –December 2017) to 553 for the first six months of 2018.  She displayed a video of a Patient Story, it was of a woman who had been a sickle cell patient at the Trust for many years.  Collecting Patient Stories was an important component in understanding how patients perceived the health care they have received and how the Trust could improve on the many different aspects of service delivery in their hospitals, and community-based health care programs.

 

The Head of Patient Experience and Public Involvement stated that the report detailed some actions for 2019.  These included: -

 

a)    Strengthening relationships with patient communities including increased Patient and user engagement.

b)    Reviewing and enhancing the use of volunteers to aid a positive patient experience.

c)     To be amongst the highest performing Trust’s regionally and nationally in relation to the Friends and Family Test.

 

The Trust regularly met with key stakeholders to share patient feedback and learning.  Reports were presented to the CCG on a quarterly basis.  Staff from PALS attended the JEAG (Joint Engagement Assurance Group) which had representatives from the CCG and Healthwatch. 

 

A Member of the Panel asked how people could be referred to the Trust if they were expressing an interest in the Council of Members.  The Head of Patient Experience and Public Involvement responded that there were leaflets and the Trust did hold drop-in sessions.  She agreed to send Healthwatch some leaflets, so they could be distributed. 

 

A Member of the Panel asked if there was a point of contact in reference to a bullet point in the  ...  view the full minutes text for item 6.

7.

RWHT Staff Recruitment and Retention pdf icon PDF 424 KB

[To receive a report on Staff Recruitment and Retention at the RWHT]. 

 

[Alan Duffel – Director of Workforce - RWHT to present report].

Minutes:

The Director of Workforce of the Royal Wolverhampton NHS Trust presented a report on staff recruitment and retention.  It was clear that the supply of staff did not meet the current demand across all NHS Hospitals and the situation was not likely to change for the foreseeable future.  It was therefore important to maximise the supply, have excellent retention, make the workforce as productive as possible and finally develop the workforce to the needs of the Trust. 

 

The Director of Workforce commented that the Trust had held one stop recruitment sessions to help with recruitment.  They had also engaged with the Armed Forces.  At the beginning of the next financial year, they would be embarking on an international recruitment initiative.  He had spoken recently with Brendan Clifford (Service Director Health) at the Council to determine what the Council could do to assist getting younger people into the health workforce. 

 

The Director of Workforce stated that retention was one of the biggest national issues being faced by Human Resources in the NHS.  There were a whole range of initiatives taking place on flexible working to improve staff retention rates.  Ideas such as rotating staff around departments were being explored, to prevent people leaving areas which were perceived as a more challenging environment.  An electronic rostering system had seen great success and was being introduced into more areas within the Trust.  The approval of the e-job planning business case, would provide a greater organisational understanding of consultant job plans. 

 

The Director of Workforce remarked that the Trust had recently approved the first year of the new Nursing apprenticeship programme, in addition to progressing the nursing clinical fellows.  The Trust was also piloting the new band four Nurse Associate role.  In addition to Nursing Apprenticeships the Trust continued to make wider use of the apprenticeship mechanism, in line with the recently approved Apprentice Approach, which saw apprentices as a way of developing individuals and opening up opportunities to local people to work within the health sector.  The expansion of the apprentice programme would also help towards establishing a career development pipeline.     

 

The Director of Workforce stated that the Trust had seen a continuous improvement in reducing the overall vacancy rate to a position where it was currently below 7%.  They were outperforming other NHS Trusts of similar size.  They wanted to keep their staff turnover rate to as low as possible, they actively measured their retention rate and were meeting their internal target.  They regularly reported the total net starters and leavers figures.  He was pleased to report that they had a greater number of starters than leavers.  The Trust were looking to increase their bank staffing levels as there would always be a need to have access to temporary staffing.  The Trust in progressing their focus on workforce efficiency and productivity, were routinely reporting on the avoidance of unused hours and the ability of the Trust to ensure shift rotas were established six weeks in advance.

 

In response to a question from  ...  view the full minutes text for item 7.

8.

NHS Long-Term Plan pdf icon PDF 204 KB

[To receive a briefing note on the recently published NHS Long-Term Plan]. 

 

[Ankush Mittal – Consultant in Public Health to present report].

Minutes:

The Consultant in Public Health at City of Wolverhampton Council presented a briefing note on the NHS Long-Term Plan.  The plan itself was a 120-page document which laid out the plan for the next ten years for the NHS, in seven chapters.  He covered the main areas outlined in the briefing note. 

 

The Chief Executive of the Royal Wolverhampton NHS Trust commented that it was important to think about the practical realities of implementing the Government plan for the NHS.  There were many different systems operating in places across the country.  It was important not to get their local plans de-railed by the national plan.  There was a discussion about overlapping pathways and where best to spend finances to achieve the best outcome. 

 

The Director of Strategy and Transformation commented that the extra money which had been allocated to the NHS just maintained the current status of affairs.  Any innovation would have to be funded as a system.  The Director of Adults referred to the cyber security attack on the NHS last year, which the NHS were still recovering from.  Digital innovation normally took years to implement. 

 

A Member of the Panel asked if there were any plans for the WMCA (West Midlands Combined Authority) to have a greater involvement in the health system.  The Director of Adults responded the main area the WMCA were involved, was on mental health.  There were currently no plans for a Greater Manchester model.   

 

 

 

 

9.

Brexit Preparations

[To receive a verbal update from Health Partners and Public Health on the preparations for Brexit]. 

Minutes:

The Director of the Royal Wolverhampton NHS Trust, The Director of Strategy and Transformation at the CCG, the Consultant in Public Health at City of Wolverhampton Council and the Head of Public Service Reform at City of Wolverhampton Council outlined their respective knowledge of the Brexit preparations at their organisations.

 

The Chief Executive of the Royal Wolverhampton NHS Trust referred to the paper that had been circulated.  He commented that there was a team in London of 200 people who were designing contingency plans for the NHS, but he had no knowledge of those plans.  From a local perspective, the main area of his concern was medicines.  This was because there was a significant amount of medicines that were manufactured in Europe.  Most of the dressings used by the NHS were manufactured in China.  All the Trust’s heart valves were purchased from the United States of America.  He hoped that the Brexit teams in London were ensuring that the supply of medicine would not be disrupted.  He suspected that the goods and the consumables used by the NHS were 90% from global companies, who would want to keep their supply chain going.   

 

A Member of the Panel asked if chronically ill patients should be stockpiling their own personal supply of medicine.  The Chief Executive of the Royal Wolverhampton NHS trusted responded that he thought it would be disastrous if patients started to stockpile medicine because there was only a given amount of production capacity. 

 

The Director of Strategy and Transformation of the CCG stated that they had to have an appointed Senior Responsible Officer for Brexit.  Mike Hastings, Director of Operations had been appointed to this position.  A meeting was planned shortly with the Trust, the CCG and the Local Authority to discuss the co-ordination of any disaster plans.  Much of the work largely fell into existing disaster recovery plans.  The CCG had an assurance role working in collaboration with NHS England.  Costs of medicine could increase if tariffs were put on EU imports.

 

A Member of the Panel asked if there were any pharmacies that were having issues in receiving medicines.  The representatives from the Trust and the CCG responded that they were not aware of any issues or stockpiling.

 

The Consultant in Public Health remarked that there was a Resilience Team within Public Health, which was working closely with health partners and the Head of Public Service Reform at the Council, to understand the local landscape and to make necessary preparations.  They were also taking national direction on the requirements.  They had been given a template, which looked at worst case scenarios such as fuel and food shortages and had been asked to consider how this would impact on services.  The Resilience Team considered public anxiety over the implications of Brexit as probably being the major public health risk. 

 

The Head of Public Service Reform stated that he was the Council’s lead on the preparations for Brexit.  He was of the view that civil unrest and community cohesion  ...  view the full minutes text for item 9.

10.

Work Programme pdf icon PDF 72 KB

[To receive the Scrutiny Work Programme]. 

Minutes:

A Member of the Panel commented that they wanted to receive an update on the STP (Sustainability and Transformation Plans) at some point in the future.  West Park Hospital was also an item to be added for later in the year or as there were developments.

 

The Director of Adults made reference to the Transforming Care Programme, which related to people with complex learning disabilities coming out of secure settings.  He had recently been discussing assessment and treatment unit availability.  Wolverhampton did not have an assessment and treatment unit in the city.  There were ongoing discussions about units available in Walsall and Dudley.  The local transforming care programme wanted to engage in discussions about what should happen to those units but did not want to formally consult.  NHS England advisors had said they did not need to formally consult, as long as there was agreement from the Health Scrutiny Panel, that engagement was satisfactory in the circumstances.  He did not see it as a problem for Wolverhampton as there was not an assessment and treatment unit in the city.  He wanted to secure the Panel’s agreement that the Transforming Care Programme should engage but not formally consult on the units in the Walsall and Dudley areas.  A formal consultation would take approximately 18 months and would delay the current plans for the Transforming Care Programme, which were scheduled to be completed in March 2019. 

 

Resolved: That the Health Scrutiny Panel agree that the Local Transforming Care Programme need only engage and not formally consult on the assessment and treatment units in Walsall and Dudley.  

 

Resolved: That the Health Scrutiny Work Programme be agreed. 

 

11.

Future Meeting Dates

Thursday, 21 March 2019 at 1:30pm

Thursday, 6 June 2019 at 1:30pm

Thursday, 12 September 2019 at 1:30pm

Thursday, 7 November 2019 at 1:30pm

Thursday, 16 January 2020 at 1:30pm

Thursday, 5 March 2020 at 1:30pm

 

Meetings take place in Committee Room 3 at the Civic Centre, St. Peter’s Square, Wolverhampton. 

 

 

 

 

 

Minutes:

The future meeting dates were reported as follows: -

 

Thursday, 21 March 2019 at 1:30pm

Thursday, 6 June 2019 at 1:30pm

Thursday, 12 September 2019 at 1:30pm

Thursday, 7 November 2019 at 1:30pm

Thursday, 16 January 2020 at 1:30pm

Thursday, 5 March 2020 at 1:30pm