Agenda and minutes

Apologies had been received from Mr T Baker, Mr W P Gretton and Mr A Stafford.

The Chairman welcomed everyone to the meeting.

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 15 September 2015). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

The Minutes of the Meeting held on 15 July 2015 were agreed as a correct record and signed by the Chairman.

Attending for this item were:

Future of Acute Hospital Services in Worcestershire - Lucy Noon, Programme Director and Jo Newton, Independent Chair of Programme Board

Clinical Commissioning Groups (CCG) - Simon Trickett, Chief Operating Officer, South Worcestershire CCG and Jo Galloway, Executive Nurse Quality and Patient Safety, Redditch and Bromsgrove CCG and Wyre Forest CCG

Worcestershire Acute Hospitals' NHS Trust - Chris Tidman, Interim Chief Executive and Andy Philips, Interim Chief Medical Officer

Lucy Noon, Director of the Future of Acute Hospital Services in Worcestershire (FoAHSW) Programme gave a presentation to update the HOSC on progress with the review process since the previous update just over a year ago.

Headline progress from this year included:

·         work with West Midlands Clinical Senate to review the clinical model ( modified option one)

·         significant progress had been made towards a revised urgent care model

·         thorough monitoring of patient safety, service quality and sustainability

·         development of implementation plans by the Hospitals Trust

·         on-going engagement with clinicians and GPs, with greater cohesion

·         pre-consultation engagement programme and review of transport issues

·         strengthening of the consultation

Acknowledging a number of delays in the process, including purdah restrictions during the general election campaign, the aim of today's update was to focus on developments since the West Midlands Clinical Senate had reviewed the proposed model. The Senate was a group of 20 clinicians from across the country, whose role was to test the model for clinical safety and quality; finance was not a part of its role.

West Midlands Clinical Senate's Independent Review

The Clinical Senate had given overall support for the proposed clinical model, as being safe and appropriate. However, the Senate did not support the proposed model for emergency medicine at the Alexandra Hospital.

The Senate had made a number of recommendations:

·         develop clear plans outlining how paediatric capacity will be provided at Worcestershire Royal Hospital (WRH)

·         re-design emergency medicine at the Alexandra Hospital (AH)

·         clarify how sick children would access appropriate services at both the AH and WRH sites

·         communicate details of emergency paediatric services to public and staff

·         demonstrate strong clinical support from front line clinicians for the model

Since publication of the report in June, there had been constructive engagement from clinicians at all levels. A clinician-led group had been tasked with the extensive process of redesigning emergency medicine at the AH to develop an enhanced service. Patient pathways for paediatric services and treatment of seriously ill children, including out of hours, had been clarified. The model had been shared with all hospital staff and stakeholders.  The Clinical Senate had praised progress made, and the next six to eight weeks would be designated to complete further work required, including approval from clinicians across the health economy.

Quality and Safety of Services

Other work from the FoAHSW Programme over the year included monitoring the quality and safety of existing hospital services and keeping partners informed of any issues.  The Quality and Service Sustainability Committee provided reports to the Programme Board, Worcestershire's CCGs, NHS England and  ...  view the full minutes text for item 754.

Attending for this item were:

Worcestershire Acute Hospitals' NHS Trust - Chris Tidman, Interim Chief Executive and Andy Philips, Interim Chief Medical Officer

Clinical Commissioning Groups (CCGs) - Simon Trickett, Chief Operating Officer, South Worcestershire CCG and Jo Galloway, Executive Nurse Quality and Patient Safety, Redditch and Bromsgrove CCG and Wyre Forest CCG

Future of Acute Hospital Services in Worcestershire (FoAHSW) - Lucy Noon, Programme Director

Chris Tidman, Interim Chief Executive of Worcestershire Acute Hospitals' NHS Trust (The Trust) provided an update on the quality of acute hospital services - including progress on quality and safety, transformation of urgent care, feedback from visits of the Deanery and also the Chief Inspector of Hospitals, pressures on maternity and paediatric services, emergency surgery and the Good Governance Institute's report into allegations of bullying and harassment at the Trust.

Progress on Quality and Safety

The Trust had an open approach to the challenges faced and external relationships with stakeholders continued to be strong. The July CQC inspection saw an 'organisation with a heart'.

An Urgent Care Transformation Team was in place. An Action Plan was being worked to, arising from the Deanery's visit.

There were increasing pressures on maternity and children's services, although governance arrangements had been strengthened.

The hospital standardised mortality rate had begun to reduce, and the process to review mortality was on track.

As outlined to the Committee during the previous update, clear safety triggers had been established to monitor existing services.

Urgent Care Transformation

The newly established Urgent Care Transformation Team had a six month programme to transform processes and was starting to take effect. There was a focus on tackling custom and practice to 'break the cycle' and improve management of patient flow. £4 million capital funding had been approved for a bigger Emergency Department (ED) and discharge lounge, both of which were planned for February/March 2016.

The Trust was committed to moving away from previous incidences of patients queued in corridors, and had invested in triage facilities and additional staff. Delayed transfers of care had reduced, although there were still some unusual spikes of high A&E ambulance activity, at both Worcestershire Royal Hospital (WRH) and the Alexandra Hospital (AH), up 17% on the same time the previous year – an audit was underway to understand whether this was merely 'a blip'.

The Trust was committed to achieving the A&E target of assessing, treating or discharging  95% of patients within 4 hours of entering A&E, which had not been attained all year and currently stood at 90%.

There was a focus on internal processes and getting 'fit to go' patients out of hospital, which was also in the patients' interests.

Deanery Visit – Medicine

Feedback from the Deanery included:

·         issues around learning from incidents, induction, handovers and elements of training and supervision – work had taken place and there was now better support of junior doctors in place

·         how the hospital works at night

Improvements to these areas were being led by the Chief Medical  ...  view the full minutes text for item 755.

Reports from the districts

From Wychavon, Cllr Smith had looked into concerns about plans to reduce Evesham hospital's restaurant services, however it looked as though the changes would go ahead.

There was concern amongst Redditch residents that services moving from the Alexandra Hospital to Worcestershire Royal would not return.

Cllr Oborski, the Wyre Forest member, was involved in work on childhood obesity, through the Children's Trust.

As a member of the Kidderminster Hospital Action Group, Cllr Oborski would contact local MPs about the concerns raised during today's discussion about progress with the review of acute hospital services – as suggested by the Worcestershire Healthwatch Chair.

Lead member reports

Worcestershire Health and Care Trust – Cllr Smith reported that the last meeting had looked at the constitution, and the estates strategy. There were also plans to create hubs to facilitate co-location of integrated services provided by the Trust and social care partners.

West Midlands Ambulance NHS Trust – Cllr Rayner's personal experience of ambulance services had been very impressive, although on arrival at Worcestershire Royal Hospital she had had to spend time in the corridor.

Joint County and District Council Scrutiny on Increasing Physical Activity – Cllr Vickery invited Committee members to join him and the Scrutiny Task Group this Friday, on a health walk starting at St Peter's Baptist Church.