Agenda and minutes

Apologies had been received from Dr B Cooper, Mrs F Oborski and Mr G Vickery.

None.

Members of the public wishing to take part should notify the Director of Commercial and Change 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 20 January 2015). Enquiries can be made through the telephone number/email address below.

None.

(previously circulated)

The Minutes of the Meeting held on 9 December 2014 were agreed as a correct record and signed by the Chairman.

Attending for this item were:

South Worcestershire Clinical Commissioning Group (Commissioner)

David Mehaffey, Director of Strategy

Dr Jonathon Thorn, Tenbury GP and Member of SWCCG

Worcestershire Health and Care NHS Trust (Provider)

Stephen Collman, Director of Operations

Mel Roberts, Clinical Services Locality Manager

The Director of Strategy at South Worcestershire Clinical Commissioning Group (SWCCG), David Mehaffey, had prepared a presentation, which highlighted the following main points:

Background

Minor Injuries Units (MIU's) were nurse led units, providing advice and treatment for a wide range of minor conditions, such as cuts and grazes, strains and sprains and minor burns.  They were not provided to deal with significant and immediate conditions that could present as being life threatening, such as suspected stroke, significant head injuries, major broken bones or crushing chest pain – where delay could be detrimental to patient outcome.

Worcestershire Position

In Worcestershire, the 5 MIU's (Kidderminster, Malvern, Bromsgrove, Evesham and Tenbury) formed a vital part of the urgent care system but operated different opening times.  Kidderminster and Tenbury operated 24 hours a day, 7 days a week, with Kidderminster seeing an average of 75 patients a day, compared to just 6 in Tenbury.

In comparison, the 3 other MIU's see around 25 patients each during their opening hours of approximately 12 hours a day and the 2 Accident and Emergency Departments (Worcester and Redditch), which are open 24/7 see around 165 patients each day.

Difficulties

Due to the extremely low throughput of patients, especially overnight, recruitment had been an issue and agency staff were relied upon to fill rota gaps overnight, which was very expensive, could be of variable quality and often at times when there were no patients in the MIU.  The issue with recruitment was the need for staff to be able to treat enough patients to maintain their competencies as required by their professional body.

Proposed Change

Supported by SWCCG, on the basis of quality and safety reasons, WHCT propose moving from opening 24 hours a day, 7 days a week, to a 12 hour opening, 7 days a week, which could be 9am to 9pm for example.

The CCG would not benefit financially as each patient contact is paid, however, WHCT may well see a financial benefit as the cost pressures associated with agency nurses would be alleviated.

An analysis of patient throughput since April 2013 (640 days) showed a weekly average of 39 patients seen during the proposed opening hours (9am to 9pm), compared to 5 patients a week in the hours proposed for the MIU to be closed.  It was also noted that on 316 days (49.3%) no patients presented outside the proposed opening hours and on 203 days, just 1 patient presented and 66 of those arrived between 8am and 9am.

Public Engagement

Consultation and meetings had taken place with neighbouring CCG's (Herefordshire and Shropshire), local Councillors and MP's, the Hospital League of Friends and staff.  In addition, there had been 2 public meetings and on-line and printed surveys, advertised widely through  ...  view the full minutes text for item 727.

The Chairman of Healthwatch Worcestershire, Peter Pinfield, had been invited to discuss a new report from Healthwatch England which outlined difficulties in the complaints process within the NHS.

Members were directed to a video which outlined a way forward https://www.youtube.com/watch?v=DzPkHX3gwLE

The Committee welcomed the work of Healthwatch England and looked forward to working with Healthwatch Worcestershire to ensure residents felt empowered to provide feedback and complain in a more open environment.

The Health and Well-being Board had asked Healthwatch Worcestershire to undertake a piece of work in the coming months and this approach was welcomed by the Committee.

There was nothing to report from District Council Members present and nothing of note from any NHS Board Meeting attended.

The Chairman commented that the Committee would be looking at Patient Flow in the coming months and access to GP services.  In addition, he had met with CQC Inspectors as part of the inspection of WHCT.