Agenda and minutes

Apologies had been received from Dr B Cooper, Mrs P A Hill, Mrs J Marriott and Prof J W Raine.

The Chairman welcomed everyone to the meeting.  Members of the Adult Care and Well-being Overview and Scrutiny Panel had also been invited to attend the discussion, and Cllr Jim Parish from the Scrutiny Panel was welcomed to the table.

None.

Members of the public wishing to take part should notify the Director of Resources in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 9 September 2014). Enquiries can be made through the telephone number/email address below.

None.

(previously circulated)

The minutes of the meeting held on 15 July 2014 were confirmed as a correct record and signed by the Chairman.

The Overview and Scrutiny manager advised that Mrs J Marriott had been nominated by District Council representatives as the Vice Chairman of the Health Overview and Scrutiny Committee.  Mrs Marriott would be formally appointed by Worcestershire County Council on 18 September 2014.

Attending for this item were:

Emma Prichard, County-wide Commissioning Manager for Stroke Services

Amanda Kimpton, Community Care Locality Lead for Redditch and Bromsgrove, Worcestershire Health and Care Trust

Bernice Jones, Deputy Head of Operations for the West Midlands Stroke Association

Emma Prichard, County-wide Commissioning Manager for Stroke updated the Committee on the county stroke programme, which was now focussing on establishing equitable specialist community stroke services in north Worcestershire, with the aim of addressing the historic imbalance between provision in the north and south of the county.

It was important to note that specialist stroke services were very distinct from general rehabilitation or stroke inpatient units. The nature and level of specialist stroke care was much more intensive and therefore beneficial for the patient.

In terms of context, figures indicated approximately 40% of patients required a period of stroke rehabilitation following discharge from hospital.  Currently this was offered across approximately 50 beds in four bases in Worcestershire (two in the south, with specialist provision, and two in the north without).

In order to address the current imbalance, two strands of work were underway – capacity modelling, using a variety of data sources to identify required capacity for the north area and the addition of eight stroke rehabilitation beds from Worcestershire Health and Care Trust.  It was pointed out that modelling for specialised stroke rehabilitation was complex as although data from local and Public Health England was available, there was an absence of national formulae.

Current provision totalled 42 bed capacity across four units. From 1 April 2015, eight additional specialist stroke beds would be available to the north area (within the Lickey Ward at the Princess of Wales Community Hospital in Bromsgrove), which was the minimum number that could be commissioned under the NICE Safer Nursing Tool.  The modelling work and discussion with colleagues would determine where to locate other bed capacity and staffing structures.

Implementation of the changes would be provided from the Better Care Fund, at a total of £470,000.

Discussion Points

Cllr Witherspoon had been very impressed by the Life After Stroke Centre in Bromsgrove which she had visited and heard about from residents. It was clarified that this centre was run by the Stroke Association and was separate to the Lickey inpatient ward.

The Commissioning Manager confirmed that there was potential to look at linking overall stroke resources in Worcestershire for sufferers of stroke as well as other conditions.

It was confirmed that health and care teams worked together closely in assessing a patient's needs for transfer home or to an alternative setting.

There were no plans to reduce specialist provision at the two units in South Worcestershire and the plans to establish an equitable service were backed by all three clinical commissioning groups.  It was important that the work to address the imbalance of service in north Worcestershire did not lead to variations in other aspects in the future.

In response to concern expressed about current outcomes for patients in the Cookley Ward and how  ...  view the full minutes text for item 701.

Attending for this item were:

Wyre Forest Clinical Commissioning Group

Heather McDonald – Head of Business Development and Operations

Dr Simon Rumley – Chair and Clinical Lead

Chris Davies – Integrated Intermediate Care Project Manager

Worcestershire County Council - Anne Clarke – Head of Adult Social Care

Worcestershire Acute Hospitals Trust – Julie Briggs, Kidderminster Business Development Manager

Dr Simon Rumley, Chair of Wyre Forest CCG and Programme lead, set out the context for the Wyre Forest Integrated Intermediate Care Programme – the nature of NHS care was changing and was very much focused on working to minimize the length of time patients spent in hospital, with the effect that the bridge between health and social care was in transition.

Chris Davies, Project Manager gave a presentation on the Programme's focus, structure, outputs and options. In January 2014 a multi-disciplinary team (including Wyre Forest CCG, Worcestershire Acute Hospitals Trust and Worcestershire County Council) had been set up to look at how existing intermediate care provision could change in Wyre Forest, prompted by the:

·         'Golden opportunity' to look at integrated working practices for the benefit of patients and carers

·         Potential implications from the County Council's consultation on the future of the Grange

·         Potential replication in resource usage

·         Future changing demograph

The aim of the Programme, which had a sixth month timescale, was to propose options for Intermediate Care Services within Wyre Forest, which would deliver improved benefits for patients and service users and be good value for money. The Programme had benefitted from a good balance of clinical, patient and managerial representation.

Currently intermediate care was based around three units, all of which had some similarities in patient types, approaches and staffing profiles:

-       Wyre Forest Community Unit (Worcestershire Acute Hospitals' Trust, WAHT) – 20 beds

-       Cookley Ward, Kidderminster (WAHT) – 17 beds

-       Grange, Kidderminster (Worcestershire County Council) – 28 + 6 beds

The draft business case and two shortlisted options for delivery were considered by the Wyre Forest CCG Board on 19 August. Model 1 was for the CCG to commission a provider to deliver Intermediate Care Services and Model 2 was to redevelop an existing empty space on the Kidderminster Treatment Centre site (KTC). Both options were given the go ahead for further investigation and agreement was reached on the model of care and (to a lesser degree), on the number of beds to be commissioned.  Conclusion of work on finances would then enable a decision to be made on the preferred option.

Regarding the Grange (a residential re-ablement and rehabilitation home), Anne Clarke, Head of Adult Social Care advised that work had started last year, through the Council's Recovery project, to look at current and future resources and approaches, which involved coming together with partners to look at how to do things differently and provide better treatment. The prospect of changing facilities with a high degree of community attachment, such as the Grange, could be difficult, but it was a journey which the Council was willing  ...  view the full minutes text for item 702.

In Redditch a serious arson attack had taken place in Abbeyvale, on housing occupied by elderly and vulnerable people. Residents had been left very frightened and the local Clinical Commissioning Group was looking at the situation.

The Wyre Forest District Council member reported on the positive development of the new 100 bed capacity extra care housing facility which had just been granted planning permission in Wyre Forest.

The County Councillor member for Bromsgrove was aware of news reports about concerns from a group of Redditch GPs about the review of  hospital services.

In Wychavon there were concerns about the amount of new housing and how to sustain health services.  It was suggested this would be something for the Health and Wellbeing Board to consider.

The Chairman would circulate information to the Committee about the numbers of young people attending Accident and Emergency.