Agendas, Meetings and Minutes - Agenda and minutes

Agenda and minutes

Venue: County Hall

Contact: Emma James / Jo Weston  Overview and Scrutiny Officers

Items
No. Item

1042.

Apologies and Welcome

Minutes:

The Chairman welcomed everyone to the meeting. Apologies had been received from Cllrs Edginton-White, Kriss, McVey and Rogers.

1043.

Declarations of Interest and of any Party Whip

Minutes:

None.

1044.

Public Participation

Minutes:

None.

1045.

Confirmation of the Minutes of the Previous Meeting

(previously circulated)

Minutes:

The minutes of the meetings on 18 October and 3 November 2021 were agreed as a correct record and were signed by the Chairman.

1046.

Development of the Integrated Care System pdf icon PDF 357 KB

(indicative timing: 10:05am – 11am)

Minutes:

In attendance for this item were:

 

Herefordshire and Worcestershire Clinical Commissioning Group

David Mehaffey, Director of Integrated Care System Development

Alison Roberts, Associate Director for Integrated Care System Development

 

Worcestershire County Council

Cllr Karen May, Cabinet Member with Responsibility for Health and Well-being

Cllr Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

 

The Associate Director for Integrated Care System (ICS) Development provided a summary of the agenda report on the development of the ICS for Herefordshire and Worcestershire (H&W), which was one of 42 across England.

 

Integrated Care Systems were about health and social care working more closely together by removing traditional boundaries between organisations thereby giving people the joined-up support they needed. With a population of around 800,000, the ICS for H&W was one of the smallest in the country.

 

The Health and Care Bill 2021 was currently going through Parliament, and at this point in time, the legislation was due to be in place for July 2022.

 

To support the cultural change, structural changes were being made and the report provided further detail on the four main structural changes; the Integrated Care Board (ICB), Integrated Care Partnership (ICP), provider collaboratives and Place-Based Partnerships.

 

The next steps were to work on the governance structure and recruiting to the ICB, which would be set up initially as a shadow organisation.

 

During the discussion which took place, the following main points were made:

 

·         A HOSC member asked about the rationale of the Place Based Partnership, how it would work for residents, bearing in mind the diverse nature of the county and whether this would be reviewed? The Director of ICS Development (the Director) explained that partnerships would link with primary care networks (of which there were 10 in Worcestershire and 5 in Herefordshire) and would align with neighbourhoods and districts, therefore he believed there was provision to work at local level – he took on board a request for this to be mapped out.

·         The Cabinet Member with Responsibility (CMR) for Health and Well-being pointed out that the Health and Well-being Board was considering the membership of Place board since the role of district councils was crucial for the collaborative approach.

·         In response to concerns that the smaller size of the H&W ICS would mean less funding, it was explained that the population and rural nature of the area was factored into its funding. The introduction of ICSs meant NHS funding was being reset and the representatives present looked forward to receiving H&W’s allocation.

·         The funding allocations for 202/23 and 2023/34 were known and the representatives were pleased with the funding formula.

·         In terms of buy-in from staff for the removal of organisational barriers and contracting regimes as part of the integrated approach, HOSC members were advised that the Covid pandemic had meant staff had already needed to collaborate to a greater extent. Nonetheless a change of hearts and minds would be required to move from a culture where money had followed activity levels.  ...  view the full minutes text for item 1046.

1047.

Cancer Diagnostics and Treatment Times pdf icon PDF 132 KB

(indicative timing: 11am – 12pm)

Additional documents:

Minutes:

In attendance for this item were:

 

Herefordshire and Worcestershire Clinical Commissioning Group:

Mari Gay, Managing Director and Lead Executive for Quality and Performance

 

The HOSC had requested a report on cancer diagnosis and treatment wait times in Worcestershire. The Managing Director and Lead Executive for Quality and Performance at Herefordshire and Worcestershire Clinical Commissioning Group (CCG) provided a summary of performance and what was being done.

 

Cancer had remained a system priority during the pandemic, although this was not to say that other services were not important.  The report set out the current performance in Worcestershire against key cancer standards, including a new standard on 28-Day Faster Diagnosis Performance. During the pandemic, referrals had reflected the national picture, so that during the first wave, the public lacked confidence in coming forward with concerns, which had then changed to near pre-pandemic levels and then high levels since March 2021, presenting particular challenges in the specialities of Breast, Colorectal, Skin and Urology.

 

Performance against the 2-week wait (2ww) referrals and the 62-Day performance was some way behind where it needed to be, and was challenging, due to access to diagnostics, staff sickness and numbers of referrals. In general referral numbers across the different cancer specialisms reflected the national picture.

 

The report set out what was being done within the specialisms of Breast, Colorectal, Skin and Urology, to address the challenges faced. These included insourcing of breast imaging to support additional weekend clinics (until March), putting in additional capacity for colorectal cancer care and enabling GPs to photograph patients’ skin concerns for earlier assessment of skin cancer.

 

Teams were continuing to work through backlogs and fortunately at the moment, monitoring of cancer outcomes across the Covid recovery period was not indicating increased harm to patients.

 

A new non-specific symptom pathway was being introduced and Worcestershire for patients with symptoms suggestive of cancer but which do not meet the criteria for a site specific 2-week wait referral.  It was expected to go live on 13 January 2022.

 

The Trust was also participating in the GRAIL/Galleri Study, through the West Midlands Cancer Alliance, which one of 8 Alliances taking part in a pilot to invite participants aged 50-77 to receive blood tests that could detect early stage cancers.

 

Workforce was the biggest concern and the Integrated Care System was liaising with the Council’s Strategic Director of People in order to focus efforts.

 

During the discussion which took place the following main points were made:

·         The CCG Managing Director (the Director) believed the variance in 2ww referrals was due to a lack of confidence in the public coming forward during the first wave of the pandemic, which was also the feedback from the focus group; people did not know what to do during Covid or did not want to bother health staff – however, importantly an increase in cancers was not emerging as a result. Some variances could not be explained however, for example very high referrals in skin cancer.

·         HOSC members were reassured to  ...  view the full minutes text for item 1047.

1048.

Work Programme pdf icon PDF 134 KB

(indicative timing: 12pm – 12:10pm)

Additional documents:

Minutes:

The following topics were suggested, which would be considered and prioritised alongside the existing work programme by the Chairman and Vice-Chairman as part of agenda planning:

·         Stroke Care

·         Update on Covid Vaccination Programme

·         Dentistry

·         Communication between Primary and Secondary Care

 

As a general point, a HOSC member suggested that the Committee should consider whether any joint health scrutiny meetings were needed between Herefordshire and Worcestershire.