Apologies were received from Councillors Craig Collingswood, Judith Rowley and Steve Simkins

Cllr Kath Perry (Chairman – Healthy Staffordshire Select Committee) welcomed everyone to meeting. Cllr Perry explained that this was informal joint health scrutiny committee meeting with members of both City of Wolverhampton Council Health Scrutiny Panel and Staffordshire County Council Healthy Staffordshire Select Committee.

Cllr Jaspal agreed to chair the meeting.

There were no declarations of interest on this occasion

The Chair welcomed David Loughton CBE, Chief Executive, The Royal Wolverhampton NHS Trust, to the meeting and invited him to present his report. 

David Loughton briefly outlined the health services delivered across 20 settings across Wolverhampton, Cannock and the surrounding area by The Royal Wolverhampton NHS Trust.  David Loughton commented on the tertiary services delivered to an estimated population of 1.9 million people covering a large geographical area.  He commented that health services are under great pressure due high demand but highlighted the important contribution of social services provision in supporting the discharge of patients and easing this pressure. David Loughton gave a recent example where the hospital had to deal with 20 ambulances arriving at the hospital when major beds were all occupied.  Comment was made that the current challenges facing hospitals were not just relating to previous six months but as a result of national political decisions not to invest sufficient funds in social services.

The findings of CQC were highlighted which reported the hospital had achieved 85% A& E target – the performance target is 95% - which will be difficult to achieve. David Loughton reported that the hospital is doing well in terms of patient safety and tertiary services and that it is receives high levels of customer satisfaction. However, the hospital is experiencing difficulties getting the 200 extra nurses recruited from the Philippines to meet the required language standards so that they can work. The hospital is however still able to attract high calibre consultants. The challenge for the hospital is that it needs nursing staff with 5-6 years’ experience now, but the necessary work to train and recruit the workforce should have been done 12 years ago to replace staff leaving the health service.

David Loughton commented that the transfer of services from Mid Staffordshire Hospital in November 2014 had worked better than expected. However, there was concern about need highlighted in a report by Sir Bruce Keogh about the national shortage of consultants and the conclusion that there were too many A&E centres. A key recommendation in the report was that the number A&E centres should be reduced and concentrated into larger centres to achieve better patient outcomes and improve patient safety.

He commented that a full A&E service is not needed as 80 per cent of patients, who currently access the hospital, are dealt with within the four hour target, and are able to be discharged without the need to be admitted. David Loughton commented that people are happy to wait in an A&E to be seen within four hours rather than wait 72 hours to see their own GP.

£35 million had been spent on improving services at Cannock Hospital which had benefited patients living in Stafford and Wolverhampton areas, for example, reduced waiting times for diagnostic treatments. David Loughton added that the rheumatology service at the hospital has a national reputation for quality.

Reference was made to proposals in the Sustainability Transformation Plans (STPs)  ...  view the full minutes text for item 3.

The Scrutiny and Support Manager, explained that health questions were sent in advance to David Loughton to respond and Members were advised that there would be the opportunity to ask supplementary questions during the meeting.  The Chair invited members of the committee to present their questions. A summary of the responses to the questions is given below

In response to a question, David Loughton responded that there were no plans to change eye clinic provision at any of the current sites. He commented on the incompatibility of the two hospital computer systems and the problems caused. David Loughton offered reassurance to the committee that work is being done to improve the situation.

In relation to the impact on maternity services at RWHT as a result of changes introduced at County Hospital, Stafford. David Loughton commented on the increased pressure on the service – the number of births have increased up to a 1000.

The difficulties in sustaining 17 A&E departments with staff available support nine departments were highlighted. As a result the pressures on the service are increasing and it not attractive to young consultants to consider a career in this area due to high levels of stress.

Thomas Sheeran commented that the procedure for discharge involves checking that the patient is safe and they be referred to outpatient services when considering their circumstances. David Loughton added that patients may need to be referred back to the hospital for further tests.   He explained that the service receives 500-600 complaints annually which is very small compared to the number of people who are seen at the hospital.

A Member praised the quality of services provided at Cannock Minor Injuries Unit (MIU) but expressed concern about the implications for the future of the service following the publication of the STP and the possibility of people having to travel further to receive treatment.  David Loughton gave a reassurance that despite the statement in the STP about changes to current provision there was a commitment that the MIU will remain open in the future.  He added that the MIU contributes two percent to the A&E performance target and the service will need to be sustaining considerable losses before the hospital would be considered for closure, despite the suggestion in the STP.

The Committee discussed nursing vacancies and the impact on the service. David Loughton commented that there are 200 vacancies for trained nurses across the hospital. The recruitment process has been delayed as only three of the 35 nurses meet the required standard of spoken English.  He explained that the vacancies have filled using the nurse bank and the hospital has not had to use agency staff. The issue of filling nurse vacancies using nurses trained abroad is a national issue and commented that UK  requires higher standard of English than that required to be able to work as a nurse in the US or Canada.

David Loughton commented that changes in the bursary paid to healthcare assistants has discouraged people from  ...  view the full minutes text for item 4.