Agenda and minutes

Apologies had been received from Mr G R Brookes, Mr P Grove, Mr M Chalk, Ms C Edginton-White and Mr J Gallagher.

The Chairman welcomed those present and reported on recent activity outside of the meetings:

-       An update on Dental Services had been received and circulated to HOSC Members following a recent HOSC meeting

-       A response from the CCGs had been received and circulated in response to HOSC’s concern in relation to Audiology Services

-       The Chairman had completed a CQC questionnaire about inspection processes, mainly asking why reports take so long to publish

-       The Chairman congratulated Worcestershire Health and Care NHS Trust in their recent ‘Good’ CQC Inspection, especially commending the ‘Outstanding’ rating given to Children’s Mental Health.

Mrs F Smith declared an Interest as her husband, Mr J Smith, was Cabinet Member with Responsibility for Health and Well-being.

Members of the public wishing to take part should notify the Assistant Director for Legal and Governance 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 24 January 2020). Enquiries can be made through the telephone number/email address below.

None.

Previously circulated

The Minutes of the previous meeting, held on 25 November 2019, were agreed as a correct record and signed by the Chairman.

Attending for this Item were:

Worcestershire Clinical Commissioning Groups

Simon Trickett, Accountable Officer

Worcestershire Health and Care NHS Trust

Sue Harris, Director of Strategy and Partnerships and STP Communications and Engagement Lead

A presentation had been circulated as part of the Agenda and Members were reminded of the vision and five aims of the NHS Long Term Plan (LTP), which had been launched in January 2019.  These were broadly around improving health and well-being outcomes, reducing inequalities, improving quality and productivity and developing a sustainable workforce.

Five priority areas had also been highlighted, including integrated primary and community services, mental health, urgent care, elective care and cancer care.

As a Sustainability and Transformation Partnership (STP) footprint, Herefordshire and Worcestershire was already working towards some of the aims and workstreams were well established.  However, the STP had to be refreshed to align with the new LTP priorities and with political changes nationally, it was now expected to be published in late Spring 2020.

The HOSC was reminded of past discussions on Maternity Services and Neighbourhood Teams for example, which had been established in order that several health and social care professionals could work together in the community with the aim of being responsive to keeping people in their own homes.  Through wider discussions, HOSC Members were also aware of other health initiatives, such as social prescribing and better planning for end of life care.

The STP was also working on Mental Health and Learning Disability services, which should see improvements to services.  Plans were also being formulated on urgent care, elective care and cancer services.

Workforce was assessed as the health and social care system’s biggest asset.  Partners were working collectively to create a resilient and sustainable employee base and developing new roles, including Registered Nursing Associates and Social Prescribers. 

Patient information would be more accessible across health system partners through digitalisation and the possibility of digital primary care, for example video consultations, was in sight.

Relationships across the healthcare organisations covering the STP footprint were developing as a system, with the collective aim of working together to ensure that patients get the safest, most effective and efficient services when they are needed.

In the ensuing discussion, the following key points were made:

·         Despite the STP needing to be refreshed, the vision and aims remained the same

·         The Neighbourhood Teams approach was working well.  It’s aim was to keep patients in a primary care setting for longer

·         There were now 11 Primary Care Networks across Worcestershire, seeing groups of GP surgeries working together to better serve the population

·         Funding had been secured for mental health transformation.  The STP was one of twelve Pilot areas which had been successful with their bid.  New models of care were being developed and would free up capacity in the system

·         When asked what would change in the refreshed STP, it was reported that there would only be subtle changes

·         Members learned that individual organisations would no longer be able to bid for capital funding by  ...  view the full minutes text for item 958.

Attending for this Item from Worcestershire Acute Hospitals NHS Trust were:

Matthew Hopkins, Chief Executive

Sarah Smith, Director of Strategy, Planning and Improvement

Richard Haynes, Director of Communications and Engagement

The Clinical Services Strategy to 2025 had been approved by the Trust’s Board in October 2019 and provided a strategy to enable clinical sustainability and financial viability.

Members noted that the hospital reconfiguration had not yet been completed and the final business case for the capital investment was yet to be submitted.  However, some of the planned changes, such as the changes to maternity services and paediatric services, were now much more sustainable.  

The shortage of available beds was being addressed.  In 2018 work undertaken in the health service had identified a shortage of 109 beds.  By the end of February 2020, 89 new beds would be in the system.

There had been significant changes to Leadership and Management and Consultants had become disengaged over time.  Stability at Board level had already resulted in positive changes to workforce engagement and Staff were increasingly able to see how their future needs would be met.

A presentation had been provided as part of the Agenda pack which highlighted priority areas.  There were three areas of activity in the Strategy which would shape the future:

-       End to end integrated care

-       Comprehensive and responsive urgent care and emergency care

-       High quality, dependable acute and specialist planned care.

Further detail was provided in relation to each of the three areas of activity, which included plans for such as those in relation to end of life care, care for people living with frailty and across workstreams such as maternity systems.

It was reported that the Strategy was designed to provide sustainability and aimed to work in partnership with the whole health and social care system, especially recognising this was important to build a resilient workforce.

The Acute Trust Board had recently approved a move to digital care records, which clinicians were quite excited about and this would assist achieving the vision for a fully integrated care system.

In the ensuing discussion, the following key points were made:

·         Local media articles had suggested that doctors were spending time out of Community Hospitals and helping in the Acute Hospitals.  In response, it was reported that this was not reflective of the situation

·         Keeping frail older people out of an acute setting was a priority and there were a number of pathways to support this and it was an area of focus in the Trust’s annual plan for 2020/21

·         It was noted that End of Life care was excellent, but more could be done to help individuals and families plan for the future by joining up work on the RESPECT initiative

·         The Committee was encouraged with the number of beds being introduced into the system

·         The Committee agreed that clear communication to residents was vital, especially in relation to the Alexandra Hospital and their acceptance of children’s cases.  It was noted that as a matter of  ...  view the full minutes text for item 959.

Attending for this Item were:

John Smith, Cabinet Member with Responsibility for Health and Well-being

Kathryn Cobain, Interim Director for Public Health

Michael Hudson, Chief Financial Officer

Steph Simcox, Head of Finance

The Chief Financial Officer reported that since the Agenda Papers had been produced for HOSC, the 30 January 2020 Cabinet Agenda had been published, which included a revised draft budget to align with the new Directorate structure.  From 1 January 2020, Public Health had transferred to the new People Directorate.

The presentation, which was circulated as part of the HOSC Agenda, outlined the Council’s overall position and further detail on the 2020/21 draft budget relevant to Health.

During the discussion, the following key points were made:

·         The Public Health Ring-Fenced Grant (PHRFG) funding for 2020/21 had not yet been confirmed, but assumptions had been made to allow for pay and contract inflation

·         The Cabinet Member reminded the Committee that 75% of the PHFRG had to be spent on delivering the Council’s public health duties as set out in the Health and Social Care Act

·         There was an element of discretionary funding, amounting to £801,000, which supported public health activity across other Council services

·         The Committee requested further detail on outcomes for the discretionary funding, such as that for Trading Standards and Adult Learning activity

·         When asked whether any of the PHRFG priorities needed to be re-aligned, the Interim Director stated that they did not and the discretionary funding was allocated according to need.  Services such as smoking cessation were being reviewed across the area of the STP in accordance with national priorities in the NHS Long Term Plan.

In response to Public Health queries arising from the Worcestershire Acute Hospitals NHS Trust Clinical Services Strategy, the Interim Director of Public Health reminded the Committee of its performance, which was generally good and supported by Public Health England.  Outcomes were generally good, but there were known pockets of health inequalities, such as levels of smoking in manual workers.  It was suggested that some of the quoted figures in the Acute Trust’s Clinical Services Strategy were inaccurate and the Chairman suggested resolving this matter outside of the meeting.

The Committee agreed to highlight the following points to the Overview and Scrutiny Performance Board for its meeting on 29 January:

·         It supported the 2020/21 draft budget and noted the change from a standalone Public Health Directorate into a function of the newly formed People Directorate

·         It noted that the Public Health Ring-Fenced Grant (PHRFG) had not yet been confirmed

·         It sought further information on the discretionary part of the PHRFG (£801,000), especially in relation to outcomes expected against the investment made

·         It looked forward to monitoring performance and progress throughout the year.

There was nothing to note at this time.

Members had nothing to add at this time.