[Opportunity to share information about priorities and risks and to update the Work Programme accordingly]
The Panel received a number of informative presentations from Partner organisations to help inform the future work programme.
1. Ros Jervis: Service Director Public Health & Wellbeing, City of Wolverhampton Council
The presentation highlighted the holistic approach that the Council was taking in relation to Health and Wellbeing and the input that each Scrutiny Panel could have. The presentation also highlighted how this approach linked back to the Council’s Corporate Plan and objectives.
The presentation showed that in many cases there was an overlap between the different Scrutiny Panels when considering Health and Wellbeing issues such as bed blocking where there might also be issues for the Adult and Safer Scrutiny Panel to consider.
Councillors queried recent news reports regarding the rationalisation of the Health Service and Officers stated that all areas were facing financial constraints and that this highlighted the importance of collaborative working and a whole system approach to service delivery. The Chief Executive of the Royal Wolverhampton Trust stated that there were no plans for the sharing of services in Wolverhampton and that the CCG and the Trust were currently in good financial health.
The Panel queried what was happening in relation to the Sustainable Transformation Plan for the area and it was stated that the deadline for submissions for the Plan was 16th September and that it was constantly changing which made scrutiny difficult.
The Chair queried whether something would be available on the STP for the next meeting of the Panel but this could not be confirmed and work that could be done regarding the Plan was very limited. It was however confirmed that there were areas of the Plan that would in the future have to be subject to and agreed to by the Scrutiny Panel.
The Chair considered that the Panel may be interested in carrying out a piece or work in relation to the roll out of the Adult Multi Agency Safeguarding Hub (MASH) in the future once it had been up a running for a little while.
2. Debra Hickman Deputy Chief Nurse, Royal Wolverhampton Trust
Mrs Hickman outlined elements of the Board Assurance Framework which was a Simple but comprehensive method for effective and focussed management of the principle risks that arose in meeting the Trust objectives.
The Panel queried how significant risks were escalated and it was noted that there were currently 7 highlighted risks with staffing as a major concern. Members also expressed some concern in relation to understanding whether or not apparently vague objectives such as ‘Creating a culture of compassion, safety & quality’ were being met. Mrs Hickman stated that the objectives were regularly monitored against both regional and national benchmarking.
The Panel also considered never events and the fact that there had been many iterations of these since 2009, it was noted that the top 2 never events in the RWT paralleled the top 2 nationally and that a large piece of work would be needed in order to understand these fully. The Panel considered that the list of never events was alarming and it was stated that the main area for improvement was the human factor when it was show that a failure to follow proper procedures and processes had led to the event. There had been a lot of investment in training to try and reduce this area of risk.
3. Wolverhampton Clinical Commissioning Group
The CCG was responsible for buying health services to meet the health needs of the local population. There were currently in the region of 250,000 people registered in the Wolverhampton area and the CCG had a budget of £341.742 million. From 1st April 2017 the CCG would have fully delegated authority for commissioning primary care, at the moment this was done jointly with NHS England.
There were 209 CCGs across the Country and only 10 had been classed as outstanding including Wolverhampton. The Chair offered her and the Panel’s congratulations to the CCG regarding this.
The situation regarding GPS was highlighted as an area for possible future scrutiny as many GP surgeries had not changed and were no longer sustainable. Some consisted of a single practitioner still in comparison to the larger more sustainable big practices and there were also issues regarding the fact that some practices were still in people’s houses and therefore closed when the GP retired.
Members queried why becoming a GP was not attractive as it appeared to pay a high salary and it was thought that there were issues in relation to people actually obtaining the required grades (3xA*) and there being a large fall out rate from this. Members considered whether a greater interface was required between nurse practitioners and junior doctors or whether the nurses could not take an additional qualification to move up to GP level. It was considered that Dentistry was to some extent taking over and that there needed to be some reconsideration of the selection process for Doctors and Surgeons to include a whole range of expertise and not just the sciences.
There were different ways in which Primary Care could be reorganised including inviting practices to become part of the Trust thus allowing them to just be clinical, the CCG stated that it would buy in the best model of care that would cater for the population. It was therefore considered that scrutiny of this future model of care could form part of the Panel’s work programme in the future.
It was also highlighted that there was a rising tide in approximately 40% of the population where it was thought that without intervention in lifestyles, 10% of these would be in the top user element in the future. The issue facing the Health Service was how to find these people and how to intervene in their lives to stop them becoming that 10%.
4. Deborah Cadman, The Black Country Partnership NHS Foundation Trust
The Trust was a major provider of mental health, learning disability and community healthcare services for people of all ages in the Black Country. Mrs Cadman outlined the five key priorities of the Trust which included - Transforming Care Together; Mental Health Alliance for Excellence, Resilience, Innovation and Training and Emerging collaboration across Wolverhampton.
One aim of the Trust was to try to reduce the reliance on anti-psychotic medication by moving into more therapeutic areas. This was hoped to be achieved by working in partnership with Dudley and Walsall Community Services and having two clinical work streams (recovery and crisis care) that would align better with other organisations and would benefit from commissioners working collaboratively across the Black Country.
The Chair stated that she would look forward to receiving updates.
Resolved: That the presentations be received and noted and attendees thanked.