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Declarations of Interest
Councillor Robinson declared an interest in item 4, ‘The Future of Local Health Services in Northern Staffordshire’ as he was the Chairman of the Unison Retired Members at University Hospital North Midlands.
The following amendments were proposed:
1. Page 4 of the minutes: Amend the wording from – “Under option 6, the community beds commissioned at Care Homes would be a mixture of short term rehabilitation or assessment, for long-term care and a small number for end of life care” amend to “under option 6 the 55 beds in option 6 would be for rehabilitation only.
2. Page 5: Amend the wording from “No option was off the table at this point.” amend to “No option was off the table at this point. The minimum safe level of beds is 40”.
RESOLVED: That subject to the amendments above, the Minutes of the meeting held on the 13 February 2019 be received as a correct record and signed by the Chairman.
Marcus Warnes (Accountable Officer, Staffordshire and Stoke on Trent Clinical Commissioning Groups (CCGs)), Anna Collins (Associate Director of Communications and Engagement) and Gemma Smith (Associate Director of Strategic Commissioning) gave a presentation which provided information in response to the questions raised at the last meeting.
Simon Whitehouse (Chief Operating Officer, Staffordshire & Stoke-on-Trent Sustainability and Transformation Programme (STP)) was in attendance at the meeting to answer questions on the STPs intentions if required.
Comments and Questions from Committee Members:
At the last meeting of the Joint Committee, Members asked for the evidence the CCG had used to demonstrate the need for change. Part of the evidence concerned muscle wastage. A question was asked on whether the activity undertaken in community hospitals particularly that based around rehabilitation, had been factored into the case for change as this was very different to that experienced at an Acute hospital.
The community beds are specifically for rehabilitation or assessment, the studies were done on people who spend most of their time in a bed. The different hospitals have different levels activity dependant of their specialism, and where the best place is for that activity. The evidence showed that if people can go home, then that is the best setting for them.
How many hours of therapy and rehabilitation are delivered at home and are family members able to provide it?
If therapy is required, then it would be in the assessment plan and would be delivered in the home setting by qualified professionals. There is a broad range of patients going into the Home First service and the services to meet their needs are available.
There may be evidence that recovering at home is better but is there confidence that the care is there. According to the Pre-Consultation Business Case (PCBC) report, the reablement team is running at 54% planned capacity and staff vacancies. Can there be an assurance that this is being addressed.
When the PCBC was written it was the early days of moving staff over to the Midlands Partnership Foundation Trust (MPFT). When this had happened the MPFT rotas were changed to ensure that there was adequate cover and that people were receiving the right care. Jobs were also being redesigned to be more efficient and ensure staff were 70% patient facing and 30% paperwork. Currently this was running at approximately 67/33% but this was improving.
Following on from the last question, it was felt that if care in the home was not available, demand for support would fall onto GPs. The number of vacancies and long term projections, particularly in the City meant that this would become a critical situation.
During the first 6 weeks of a patient being discharged the CCG commissioned through its community services provider would ensure that care did not default to the GP. Two years ago, there were less than 2,500 hours of care in the North provided to assist reablement, this is now 6,200 so demand was being met. Recruitment was still being ... view the full minutes text for item 6.