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Declarations of Interest
a) Councillor Dave Jones declared an interest in item 5, University Hospital North Midlands, as his wife works for the hospital in a clinical capacity and for their Unison branch.
b) Councillor Kath Perry declared an interest in item 4, the Adult Learning Disability Community Offer 2022, as she was a friend of an organisation supporting people with learning disabilities.
RESOLVED: That the Minutes of the Meeting held on 19 March 2019 be received as a correct record and signed by the Chairman subject to the following amendments:
a) Minute 62 - page 3 paragraph 1, post code should be ST17 not SK17.
b) Minute 62 - page 3 paragraph 4, delete the word not after ‘counter intuitive of.
c) Minute 65 - page 7 final paragraph add the words “due to the link between deafness and dementia” after the words “people healthy”…….
NOTE BY CLERK: Upon checking SK17 was correct and should remain in the minutes.
Report of the Director for Health and Care.
Councillor Alan White, Deputy Leader and Cabinet Member for Health, Care and Wellbeing; Richard Harling, Director of Health and Care; Amy Evans, Commissioning Manager, Learning Disabilities Commissioning Team; and, Cathy Prendergast, Head of Nursing for Learning Disabilities were present at the meeting to present the report and answer questions.
The Committee considered a report of the Cabinet Member for Health, Care and Wellbeing on the day opportunities for people with learning disabilities and/or autism. The report was due to go to Cabinet on 19 June for consideration and the Select Committee was being asked for comments prior to decision. The Cabinet report was attached to the agenda for members to consider.
The purpose of Staffordshire’s Adult Learning Disability Community Offer 2022 Programme was to establish the eligible care and support needs of adults with a learning disability and/or autism and ensure that there are appropriate and sustainable services across the county to meet them.
The programme included considering the future of day opportunities. Engagement had taken place with key stakeholders the outcome of which had now been completed and used to analysis the options. In addition, the paper provided an overview of the remaining Learning Disability Services that are currently provided by the County Council and the externally commissioned respite service, whose contract was due to expire on 31st March 2020.
Reassurance was requested over the quality of services and how this was monitored, particularly since the national light touch regime introduced in 2015. In response, the Committee was informed that whichever method of procurement the local authority chose to use, be it; a single provider; a framework which was a range of providers appointed for a set contract period; or a dynamic purchasing system, where providers are appointed at the outset, and new providers could be appointed during the life of the contract. Whichever method is chosen, the local authority would want a clear set of standard specifications and range of standards to measure performance against.
A Member expressed concern that some of the more rural areas of the County, e.g. Staffordshire Moorlands had a limited number of providers and little transport links between communities. It was acknowledged that it is always likely to be more difficult to find providers to serve a rural areas, however a procurement offered an opportunity for the Council to clearly specify the services required and attract new providers or existing providers into new areas
A question was asked on whether the tightening up of standards and increased monitoring could lead to a reduction in the number of providers prepared to work in rural areas. Again, the challenges of providers operating in rural areas was acknowledege, but it was stressed that it was essential to hold providers to account against an objective set of standards. Transport availability and its costs would be looked at
The funding rate for certain tasks such as personal assistants hadn’t increased for a number of years and it was felt that this was putting families under financial pressure. The ... view the full minutes text for item 3.
Report of the Chief Executive of the University Hospital North Midlands.
The Chief Executive of the University Hospital North Midlands (UHNM) Tracy Bullock; Helen Ashley, Deputy Chief Executive and Director of Strategy and Performance; and Jonathan Tringham, Acting Chief Finance Officer attended the meeting.
It was reported that staffing levels and retention of nursing staff was currently 90% which was particularly good for a Hospital Trust. There were work areas where consultants were difficult to recruit, such as care for the elderly, respiratory and A&E, but this was similar throughout the Country. Effort had been made to develop new roles such as advanced nurse practitioners and increasing the number of apprentices, but this did take time to train people to the required levels. The use of agency staff was low as the hospital had a bank of hospital staff who it called on as a first option. A Member asked why Administration and Clerical staff had a relatively high turnover. In response, it was felt that this could be due to promotion or people leaving the area. The Trust had also recently gone through a “Management of Change” exercise which may have created anxiety for some staff.
The Committee asked if hybrid appointments (more than one partner involved) were being considered both at medical and nursing levels. The understanding of both cultures was important. In response, the Trust informed Members that they had explored this and had varying success. Conversations were taking place with the Midlands Partnership Foundation Trust about the rotation of Health Care Assistants and joint Consultant appointments were already in place between UHNM and Mid Cheshire and UHNM and Shrewsbury and Telford.
UHNM was asked if The County Hospital A&E was due to close. In response the Committee was informed that there were workforce challenges but there were no plans to close it. However, the service needed to be safe and sustainable which may mean that the service models needed to change. There were currently concerns over the usage of the Birthing Unit and the Trust was due to launch a campaign to increase the usage. Currently there were only 1 to 3 babies born there per month on average, when there should be 350 per year to remain viable. A Member asked if the number of people who could have used The County but hadn’t was available. It was agreed that his information would be forwarded.
With regard to Paediatric provision, the only area discussed recently had been the minor injuries unit. There were continued instances when young children were taken to the Hospital for minor illnesses (not injuries) and had to be referred to a Primary care provider. This model hadn’t changed for some time and there were no proposals to change services in the near future.
In relation to the treatment of cancer, the data in the report was considered and discussed. It was reported that the Hospital were looking at pathways so that only those who needed to see a consultant did so, and those people who needed less specialist advise ... view the full minutes text for item 4.
Report of the Scrutiny and Support Manager.
The Scrutiny and Support Manager presented the report which outlined the activity the Borough and District Councils since the last meeting.
It was reported that the first meeting of the East Staffordshire District Council Health Committee would be considering its work programme. A special meeting to discuss the Virgin care contract and local GP services would be held later in the year.
The next meeting of the Lichfield District Council Health Committee was to be held soon to discuss the work programme.
The Chairman noted that there had been a number of items in the District and Boroughs work programmes concerning the capacity of primary care.
Newcastle Borough Council were considering deprivation, obesity and the effect of school holidays (holiday hunger).
A member explained that there had recently been a presentation to the Health and Wellbeing Board
Staffordshire Moorlands had a new Committee which were currently considering their work programme and had received an update from Healthwatch and on Leek Hospital.
Tamworth Borough Council were considering a number of items which fell under the Safe and Strong Committee remit. The Chairman asked for the Safe and Strong Select Committee Chairman to be informed for information.
a) The report be received
b) The Chairman of the Safe and Strong Select Committee be informed of Tamworth’s Work Programme for information.
Report of the Scrutiny and Support Manager.
The Scrutiny and Support Manager presented the Committees Work Programme report.
The Committee discussed its remit and different ways of scrutinising providers who were not within the Counties geographical area, such as Royal Wolverhampton Hospital which fell under the Wolverhampton City Councils Scrutiny Committee remit.
The Committee considered the draft work and felt that workforce planning was an important issue as was Mental Health, including Children and Adolescent Mental Health services which was currently due to be considered at Committee in December 2019. It was felt that this was too late and the Committee asked for this to be moved forward in the work programme.
The Committee were reminded that there would be an additional Joint Scrutiny meeting with Stoke on Trent City Council to consider the results of the North Staffordshire CCG consultation.
Members felt that there was sometimes a lack of information from some of the partners and they were not being kept up to date with all service changes that took place.
The Committee was informed that an afternoon meeting on the 15 July 2019 was now proposed to consider the CCG commissioning and quality monitoring and the re-procurement of the Improving Lives Community Services provision (Virgin contract). The Committee asked for the proposed CCG merger to be added to this session as there was concern that there may be a significant change if commissioning intentions.
The Committee were reminded that if there was an issue which was not on the work programme which they felt needed considering they could raise it at any meeting or with the Chairman or Officers.
a) The Work Programme be noted
b) That the Scrutiny and Support Manager write to all the Health partners reminding them of the need to keep the Committee informed of events and service changes.
c) The 15th July afternoon meeting be added to the work programme to consider the proposed CCG merger: the CCG commissioning and quality monitoring; and, the re-procurement of the Improving Lives Community Services provision.
d) The an item on Mental Health service provision (adult and CAMHs) be included in the Work Programme.