Agendas, Meetings and Minutes - Agenda and minutes

Agenda and minutes

Venue: County Hall, Worcester

Contact: Emma James / Jo Weston  Overview and Scrutiny Officers

Media

Items
No. Item

1066.

Apologies and Welcome

Additional documents:

Minutes:

The Chairman welcomed everyone to the meeting.

 

Apologies had been received from Committee members, councillors Salman Akbar, Sue Baxter, Mike Chalk, Jo Monk, Natalie McVey and Kit Taylor, as well as Cabinet Members Adrian Hardman and Karen May.

1067.

Declarations of Interest and of any Party Whip

Additional documents:

Minutes:

None.

1068.

Public Participation

Additional documents:

Minutes:

None.

1069.

Confirmation of the Minutes of the Previous Meeting

Previously circulated

Additional documents:

Minutes:

The Minutes of the Meeting held on 9 May 2022 were agreed as a correct record and signed by the Chairman.

 

1070.

Workforce Pressures pdf icon PDF 589 KB

(indicative timing: 10:05am – 11am)

 

Additional documents:

Minutes:

Sarah Dugan, Chief Executive of Herefordshire and Worcestershire Health and Care Trust (HWHCT) introduced the report and explained she was present in her capacity as Co-Chair of the People Board within the Integrated Care System.

 

Workforce was a very broad topic, and there were various areas which Committee members may want to explore.

 

In Worcestershire and Herefordshire around 16,500 people were employed by the NHS, 12,375 of whom in Worcestershire. Regarding vacancy rates and staff turnover, figures in the Agenda report included those who may have moved to other NHS organisations within the NHS family.  COVID had brought incredible challenges and there were some hot spot areas with higher numbers of staff approaching retirement. During the pandemic, use of temporary staff had increased significantly, and it was hoped to reduce use of agency staff, which was expensive. The absolute priority was to attract and importantly, to retain a permanent workforce, for example by trying to be as creative and flexible as possible to make jobs attractive, including international recruitment when needed.

 

Worcestershire’s Primary Care workforce was fortunately very strong, although there were some hot spots in both primary and secondary care sectors, for example practice nurses, haematology and mental health. Mental Health was an example of an area where there had been recent development resulting in new posts which was positive, but there was not a ready supply of staff, although for mental health this was a short-term problem since there had been a big increase in young people training in this field. The Board was really keen to encourage local people to consider NHS roles, which spanned a huge range of job types.

 

Workforce pressures within domiciliary care and social care were significant and organisations were trying to work more as a system and look at practical considerations such as transport.

 

It was important to do as much as possible to mitigate the significant pressure on staff from the cost of living.

 

The report included the range of solutions in place to address workforce pressures. The People Board comprised 30 people from a range of organisations who all wanted to make a difference and there was a local as well as national People Plan. Following the huge success of the call for people to help the NHS during the pandemic, the reservist programme was a new area of work to develop staff resources from people who may be employed in other jobs but have skills to help the NHS at times.

 

A Health and Well-being Hub, funded nationally, was available to support staff and was particularly beneficial to smaller organisations.  It was also important to note the ‘game changing’ addition of the Three Counties Medical School.

 

The Chairman invited discussion and the following main points were made:

 

·       Reassurance was sought about the impact of NHS staff being redeployed to the COVID vaccination programme to assist with further rounds of vaccinations, however it was confirmed that all staff had now returned to their usual posts, and the vaccination programme was  ...  view the full minutes text for item 1070.

1071.

Update on End of Life Care pdf icon PDF 168 KB

(indicative timing: 11am – 11:45am)

 

Additional documents:

Minutes:

The Chairman acknowledged the additional data which had been requested and the representatives present apologised for its lateness. (attached to Minutes)

 

Dr Sarah Onions, End of Life Care Clinical Lead for Herefordshire and Worcestershire Clinical Commissioning Group (HWCCG) and St Richard’s Hospice Medical Quality Lead and Hospice Palliative Care Doctor, introduced the report which provided an update since the last discussion with the Committee in 2020.

 

Over the last two years the national End of Life Care team had become very proactive and there was very strong working between NHS England and Improvement (NHSE&I) and HWCCG, with priorities now aligned. A new self-assessment framework was proving very helpful for the CCG to verify services and feedback from NHSE&I for Herefordshire and Worcestershire (H&W) was complimentary with the area often seen as an exemplar. Many priorities were already in the Strategy for H&W, for example integrated working and a 24/7 advice provision to professionals but also to patients and families. 

 

An external view of services had been commissioned as well as forecasts of future trends in population and areas of development. Funds had also been secured from NHSE&I to help with integrated access and inequities.

 

Caitlyn Adkins, Ageing Well and End of Life Care Project Manager referred to work behind other priorities, for example the digitalisation of ReSPECT forms which would be accessible to any health professional and the new ReSPECT training programme which was being taken on as a national resource. Developments in education and knowledge had in many ways been brought forward by necessity due to COVID.

 

The Chairman invited discussion and the following main pints were made:

 

·         A HOSC member asked for an example of a patient journey through end of life care, and Dr Claire Curtis, Consultant in Palliative Medicine and Clinical Director for Specialist Palliative Care Services with Herefordshire and Worcestershire Health and Care Trust (HWHCT) spoke about care provided recently for a young woman in her 20s with metastatic bowel cancer who had in the main been cared for at home, under her GP and community care home, with hospital visits minimised which was her preference. Her wish was to die at St Richard’s Hospice, with the team she knew and who were helping her to prepare, for example by completing a book for her son.

·         Feedback was important and was therefore sought from as many sources as possible, for example hospices and bereavement questionnaires from community hospitals, and the different agencies involved had different mechanisms to ensure this was acted on, for example reporting to the organisation’s Board and sharing across the learning network.

·         Regarding options for end of life care, conversations would be started early on with the individual and family and would continue since needs and wishes may change.

·         In response to a question about how long community hospitals had sought feedback from relatives, this would be verified.

·         Worcestershire Acute Hospitals Trust had pathways to facilitate safe and quick discharge for patients who entered hospital not envisaging  ...  view the full minutes text for item 1071.

1072.

Hospital at Home Service pdf icon PDF 146 KB

(indicative timing: 11:45am – 12:15pm)

 

Additional documents:

Minutes:

Jenny Dalloway, Lead Commissioner for Mental Health, Learning Disabilities and Children for Herefordshire and Worcestershire Clinical Commissioning Group provided a brief introduction of progress on the service model for the Hospital at Home Service, following the earlier discussion with the HOSC in September 2021.The Service for older adults with functional mental health illness had evolved from a temporary service change during the COVID pandemic, where the focus was for people to remain at home.

 

The Agenda report set out the findings of the initial consultation to make the change permanent, the proposals for which had been fully supported by the System. It was explained that some differing views had come through, although of note these were from stakeholders asking ‘what would happen if’ questions, and not from those using the Service. The original consultation had occurred during the pandemic, therefore a further consultation was planned to be really clear on the impact for patients and carers, and it was hoped that the further communication would address any concerns.

 

The Chairman invited discussion and the following main points were made:

 

·         HOSC members praised the positive outcomes of the Hospital at Home Service and the initiative in taking forward the changes.

·         When asked for examples of a patient journey through the Service, Jayne Westwood, Service Manager for Older Adult Mental Health at Herefordshire and Worcestershire Health and Care Trust (HWHCT) explained that the two main aspects of the Service were around enabling a patient in a hospital ward to go home or to avoid someone at home needing to go into hospital. Typically, the duration of care was two to four weeks, after which care would continue with community care teams.

·         When asked about the benefits and challenges of the changes, the representatives advised that the main benefit was avoiding stay on a hospital ward, which were also more difficult for families to visit and most patients and their families wanted them to stay at home. Hospital at Home staff were multi-disciplinary and able to visit up to four times a day, a level of care which was rare in hospital and very effective. So far it had not been necessary to use any external beds outside of the county.

·         Sue Harris, HWHCT Director of Strategy and Partnerships pointed out that home treatment for mental health had been around for a long time, therefore being able to do this for older adults with mental health illness was really great.

·         There had been no feedback to suggest that public transport access had been an issue and information was provided about hospital transport. Previous experience indicated that patients had not always chosen the nearest facility for hospital stays.

·         It was clarified that the hours for the Service were 8am – 8.30pm, with a 24 hour/7 day a week crisis team although it was very rare to require this.

·         It was explained that the Service was able to provide more specialised needs-led service, whereas the all age provision lacked expertese with the co-morbidity of older  ...  view the full minutes text for item 1072.

1073.

Work Programme pdf icon PDF 134 KB

(indicative timing: 12:15pm – 12:20pm)

 

Additional documents:

Minutes:

There were no additions to the work programme, apart from the future updates requested during the course of the meeting on:

·         Workforce pressures

·         End of life care

·         Hospital at Home Service