Agenda and minutes

Apologies had been received from Mr M Johnson and Prof J W Raine.

None.

Members of the public wishing to take part should notify the Head of Legal and Democratic Services 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 2 March 2015). Enquiries can be made through the telephone number/email address below.

Mr Neal Stote, Chair of the Save the Alex campaign addressed the Committee and raised the following main points, specifically in relation to Item 6:

·         The Chairman and Chief Executive of Worcestershire Acute Hospitals NHS Trust had taken some time to speak out following the news of five A&E Consultants resigning and when eventually doing so, would not discuss the reasons why.  This lack of communication was concerning and fuelled the discussion that there was an unacceptable management structure at the Trust

·         Mr Stote, along with MP's and Council Leaders, attended a meeting with the Secretary of State for Health and the Chief Executive of the Trust Development Authority on 23 February and informed them of some concerns, including:

o   WAHT was not financially sustainable, neither historically nor at present, with the forecast that this financial year, a deficit of £25million would be posted

o   there were staffing issues, including widespread allegations of bullying.  In addition, it was suggested that staff fear patient safety due to being overstretched, having to work extra shifts and some nurses working outside of their usual area.  The number of vacant posts was around 250 and the agency spend was estimated to be overspent by around £8million

o   quality was a concern, with many targets being missed, including key cancer targets.  A&E targets at Worcestershire Royal Hospital had not been met in over twelve months and staff reported treating patients in corridors was commonplace

o   the January 2014 Independent Review Panel report stated that Worcestershire Royal Hospital and University Hospitals Birmingham had no capacity if the Alexandra Hospital in Redditch were to close.

Mr Stote also added that Worcestershire Healthwatch had reported that residents from the wider Redditch area were unsettled with recent events, especially as Worcestershire Royal Hospital had been running under extreme pressure for a number of months.  The situation was unacceptable.

(previously circulated)

The Minutes of the Meeting held on 21 January 2015 were agreed as a correct record and signed by the Chairman.

Attending for this item were:

Worcestershire Health and Care NHS Trust (Provider)

Dr Bernie Coope, Clinical Director, Older Adult Mental Health Psychiatrist

Sue Harris, Director of Strategy and Business Development

Hilary Thorogood, Early Intervention Service Manager

Integrated Commissioning Unit (Commissioner)

Jenny Dalloway, Lead Commissioner – Mental Health and Dementia

The Committee (HOSC) had asked for an update on the provision of Older People's Mental Health Services within Worcestershire, including Dementia. This followed the HOSC's earlier overview of Mental Health Services and its discussion about the Mental Health Liaison Service.  The aim was to extend HOSC's understanding of mental health services provided in the County, the policy changes (past and future), the importance of interagency working across the system and how progress will be made to parity of esteem between physical and mental health.

Representatives from the service provider, Worcestershire Health and Care NHS Trust, and from the Integrated Commissioning Unit had been invited.

Dr Coope gave a presentation outlining:

·         What is dementia?

·         Looking back – what has changed?

·         What services are provided, who do they support, what do they do?

·         Current challenges

·         The future look

During the presentation he made the following main points:

In his view dementia was the single most important health issue affecting the County. Some of the facts around dementia were:

·         One third of the UK population would develop dementia

·         In the UK 1 in 14 people over 65 have dementia

·         Up to 70% of people in a care home have a form of dementia

·         People with dementia stay in hospital, on average, 5 days longer than those without dementia

·         The cost of to the UK is greater than heart disease, stroke and cancer combined, costing the UK economy over £26 billion per year

·         It was a condition whose diagnosis was feared more than cancer

·         Worcestershire has an estimated 8500 people living with dementia and this is forecast to increase by 40% over the next 12 years

·         Just over 50% of the local population with dementia have received a formal diagnosis

The most important question was what could be done to help a person living with dementia live as well as possible.  The focus was on:

·         Earlier access to services: there was investment in early diagnosis and advance care planning

·         Support for carers: Improvements made in carer involvement and support

·         Choice and integration: Importance of different support options including Home based care, respite, supported activities

People needed to be at the centre of decision making and it was essential to work together across professional and organisational boundaries, including voluntary and community groups and private sector providers; dementia was everyone’s business and a system wide approach was needed. 

The aim was for one care plan, a named care co-ordinator and care plans agreed in advance.  Dr Coope stressed the importance of early diagnosis, which was mostly carried out by the Early Intervention Dementia Service.  This could be challenging as some patients could not recognise that they had symptoms.

There were a variety of solutions across sectors to  ...  view the full minutes text for item 734.

Attending for this item, from Worcestershire Acute Hospitals NHS Trust (WAHT), were:

Harry Turner, Chairman

Penny Venables, Chief Executive

Chris Tidman, Director of Resources/Deputy Chief Executive

The HOSC Chairman explained that he had invited representatives to the meeting following the announcement that five Accident and Emergency (A&E) consultants had resigned en masse.  He also reminded the Committee of its role in relation to this item, which was to look at the clinical safety, clinical sustainability and financial ramifications.

The WAHT Chief Executive summarised the position and the following main points were made:

·         there had been some issues vocalised in private conversations, however, everyone concerned was entirely focussed on clinical safety and clinical sustainability

·         the recruitment process, to replace colleagues, was already underway and statutory interview requirements would be undertaken

·         all Consultants had committed to working their notice and would not leave before May 2015.  Discussions had taken place to determine if anyone would work longer

·         the Trust acknowledged that organisations and individuals would have concerns, however, after eleven days, it was too early to answer every query

·         other local Trusts were working proactively with WAHT to provide assistance.

In the ensuing discussion, the following main points were raised:

·         the Trust had agreed with the Consultants that they would not discuss the reasons for the resignations in public, although one Member understood the Consultants were happy for their reasons to be shared

·         different views were expressed in the resignations and discussions had taken place, but no one had suggested bullying or harassment as reasons

·         the Trust had successfully recruited to 32 Consultant posts recently and all appointments were now across all sites in Worcestershire, rather than being site specific.  This working practice was now the same for all Anaesthetists

·         the ongoing work on the future of Acute Services in Worcestershire would continue and all contributors would ensure patient safety and sustainability was in place

·         in relation to the financial implications, there continues to be a national picture of hospitals reporting a deficit, the latest figure suggesting 75% of Foundation Trusts doing so.  WAHT is no different

·         the Trust has faced many pressures over the winter period and delayed discharges and cancelled operations have implications for income generation

·         the next three years for integration of health and social care would hopefully provide some stability and a platform for cost improvements.  Everyone was in agreement that all elements of the health economy were vital to an improved position

·         in relation to other Trusts providing assistance, the range of support had ranged from immediate offers to opportunities for partnership working both in the short term and medium term

·         One Member commented that staff morale seemed very low with suggestion that senior management was not listening.  When asked whether there was a structural issue and what steps would be taken to rebuild relations, the Chief Executive stated that recruitment in Theatres had been recently successful, A&E Nursing roles had been enhanced and a model, where skills were developed, had been adopted.  There had  ...  view the full minutes text for item 735.

The Chairman deferred this item until the next meeting.