Agenda and minutes

The Chairman welcomed everyone to the meeting, and paid tribute to Matthew Hopkins, as this would be his last Health Overview and Scrutiny Committee (HOSC) meeting before he left his role as Chief Executive of Worcestershire Acute Hospitals Trust – he thanked him for his candid input to Scrutiny which was very much appreciated.

Apologies were received from HOSC members Councillors Salman Akbar, Richard Udall, Tom Wells, Cabinet Member Karen May and from Mark Fitton, Strategic Director, People. 

None.

Members of the public wishing to take part should notify the Democratic Governance and Scrutiny Manager 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 14 June 2023). Enquiries can be made through the telephone number/email listed in this agenda and on the website.

None.

Previously circulated

The Minutes of the Meeting held on 10 May 2023 were agreed as a correct record and signed by the Chairman.

The Chief Executive (CE) of Worcestershire Acute Hospitals NHS Trust (WAHT) introduced the Agenda item and pointed out that whilst his time at WAHT had been a good period in his career, a personal disappointment was that he was moving on at a point when the challenges of improving patient flow had not been resolved completely.

Referring to HOSC members’ visit to the new Accident and Emergency (A&E) Department that day, the CE explained that this was one element of several which needed to work well together for patient flow to improve, as well as working to keep people well at home. There was no lack of effort or focus, but WAHT was unusual in having been hit by every round of strike action.

Referring to the report, the Herefordshire and Worcestershire Integrated Care Board (HWICB) Managing Director explained that while the NHS was still recovering from the Covid pandemic, improvements were starting to be seen in cancer and diagnostics, as well as elective care. Some improvements were being seen in Urgent and Emergency (U&E) care, definitely in keeping people well at home including work with West Midlands Ambulance Service (WMAS).  WAHT had been subject to many reviews, therefore areas of focus were clear, such as internal flow, speedy discharge, prevention, getting people home and care for Worcestershire’s increasing elderly population. Performance for patients on pathways was really good but there was more to do on every part of the flow system. A system-wide review was looking at bed-base requirements for the future, and more would be needed.

The system had recently been subject to two reviews on patient flow which had produced specific recommendations and a system-wide action plan was being formalised.

WAHT’s new Interim Chief Operating Officer (COO) highlighted the need to focus positively and build detailed plans for improvement around realistic stretch targets, which were embedded in the organisation, owned by the relevant departments and backed up by monitoring and governance. He envisaged that plans would be implemented across 1-12 months depending on whether they were short or long-term aims and would involve close working with HWICB and communication with stakeholders.

The HWICB representative explained that many aspects of the new 14 point improvement plan would be familiar to the HOSC from discussions to date. Worcestershire received additional support (as a tier two area) and she had asked for there to be no further external reviews if possible, but for support to be provided for any areas of improvement as required. Pace was the key approach moving forward.

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

·         The Chairman noted that the additional funding for winter 2022/23 had ceased in April 2023 and asked about the implications for services. It was explained that one of the uses of funding for this winter was for the additional extra care beds with Herefordshire and Worcestershire Health and Care Trust (HWHCT) and some spot purchasing through Worcestershire County Council for nursing home beds to help improve  ...  view the full minutes text for item 1145.

The HOSC Chairman asked the WAHT Chief Executive (CE) to set out leadership arrangements for his departure. The CE referred to the collaborative approach with other acute hospital trusts over recent months, which would be the direction of travel for WAHT. South Warwickshire University NHS Foundation Trust had been working on a provider model with the Wye Valley Trust and George Elliot Hospital Trust, with WAHT being part of a pilot. The WAHT Board would now seek formal membership of the Group from 1 August, pending consideration by the various Trust Boards involved and this would also bring continuity at Chief Executive and Chair level. A Managing Director would then be appointed to WAHT, hopefully by the end of July. Importantly, the WAHT Board would remain an organisation in its own right and the staff set of conditions for success had been shared with the Group Chair. Thegovernance arrangements would need to be discussed, since WAHT was 70-80% of the size of the other hospital trusts combined, however the outgoing CE believed it was the right direction for Worcestershire. 

The HOSC Chairman also sought an update on the Garden Suite Ambulatory Chemotherapy Service and the WAHT CE reminded members the Service had been temporarily moved from Redditch to Kidderminster Hospital at the start of the pandemic as part of infection control measures, but had since been moved back to adequate facilities at the Alexandra Hospital in Redditch. Feedback from staff and patients was positive, and WAHT was working on how to continue to provide chemotherapy quickly and close to patients’ homes, to meet rising cancer diagnosis rates.

In light of this update, it was agreed to remove this item from the Work Programme.