Agenda and minutes

Healthy Staffordshire Select Committee
Monday, 11th June, 2018 10.00 am

Venue: Oak Room, County Buildings, Stafford. View directions

Contact: Jonathan Lindop  Email: jonathan.lindop@staffordshire.gov.uk

Items
No. Item

1.

Declarations of Interest

Minutes:

There were none on this occasion.

2.

Minutes of meeting held on 7 March 2018 pdf icon PDF 155 KB

Minutes:

With regard to minute 74, the Chairman explained the delay in writing to the Chairman of the Independent Reconfiguration Panel regarding the Committee’s concerns over the inadequacy and time taken to receive a response from the Department of Health and Social Care to the referral made by the County Council to the Secretary of State in January 2017 regarding the provision of healthcare services at Bradwell Hospital, Newcastle under Lyme and assured the members that this would now be implemented.

 

RESOLVED That the minutes of the meeting held on 7 March 2018 be confirmed and signed by the Chairman

3.

Minutes of the Joint Accountability Session with University Hospitals North Midlands NHS Trust on 16 April 2018 pdf icon PDF 138 KB

Minutes:

With regard to minute no 3, the Trust agreement to look at individual pathways and offer a trajectory for all specialities in terms of driving up cancer performance to the required 85%, the Scrutiny Manager confirmed that information had been received from the Trust and would be circulated to members. 

 

RESOLVED That the minutes of the Joint Accountability meeting held on 16 April 2018 be confirmed and signed by the Chairman.

4.

Staffordshire and Stoke-on-Trent Sustainability and Transformation Partnership - Update pdf icon PDF 190 KB

Report of the Staffordshire and Stoke-on-Trent Sustainability and Transformation Partnership - Chief Operating Officer

Minutes:

Mr Simon Whitehouse, Programme Director, Ms Tracy Parker-Priest, Chief Operating Officer and Mr Roger Wade, Medical Director presented an update from the Staffordshire and Stoke on Trent Sustainability and Transformation Partnership (STP): Together We’re Better.

 

There was increasing clarity around the process of implementation of the STP. The vision was to create a centre of excellence for integrated health and social care provision across Staffordshire and Stoke-on-Trent based around local communities and delivered by strong integrated community teams. The STP was preparing its public consultation business case and would continue to update the Select Committee as a key stakeholder. There were challenges in Staffordshire in terms of primary care, secondary care and meeting patients NHS constitutional rights but the STP were developing a clinical model which was sustainable, met statutory requirements and was financially and clinically viable.  They were committed to an engagement process which would be transparent and robust.

 

Currently, the STP were working through implementation priorities for each work stream. Mr Whitehouse acknowledged that in some areas, significant service change would be required while in other areas, the STP could move more quickly to deliver integrated multi-disciplinary care teams and this was clearly in the interests of local communities.  However, in emergency and urgent care, the challenges of the winter period had been significant and widely shared. The STP recognised the need to be better prepared in future and would make changes through a process of consultation and engagement where required. It was not possible to be sure at this stage what the clinical model would look like until after engagement with and feedback from the community. In order to keep to a tight timeframe however, the STP was shaping the engagement process and working to deliver what changes it could do, now.

 

Given the STP commitment to fully integrate mental health services with physical health services, a Member asked about patients who were currently receiving mental health services outside of the county.  Mr Whitehouse confirmed that there was a clear focus on mental health services within the STP and acknowledged that some patients were receiving specialist treatment out of the county boundary. Work was underway on how to bring these patients back into the county and to actively reduce the number having to cross the county boundary. Some repatriation of existing patients would take place, but Mr Whitehouse warned against full repatriation where for some patients with the most complex and severe conditions, specialist support could only be accessed out of county.  The STP planned to bring work streams to the Select Committee as they developed and Mental Health Services would be one such.  

 

Several Members shared their concerns about challenges in the workforce which underpinned the strategy. Mr Whitehouse said that the STP was addressing these at several levels. He reported progress made around primary care although they were not complacent about work still to do. The STP was looking at the skill mix as a priority and the national shortage of GPs was widely acknowledged.  ...  view the full minutes text for item 4.

5.

Staffordshire and Stoke-on-Trent Sustainability and Transformation Partnership - Urgent and Emergency Care pdf icon PDF 179 KB

Report of the Staffordshire and Stoke-on-Trent Sustainability and Transformation Partnership

Minutes:

Becky Scullion, Commissioning Lead and Dr Zia Din, Clinical Lead, presented an overview of the Urgent and Emergency Care (UEC) programme, responsible for delivery of simplified access to urgent and emergency care and developing services for people to use as an alternative to accident and emergency. 

 

The programme had been developed with clinicians and would be part of the public facing discussions to be held as part of the wider STP consultation process. The key deliverables were aligned to the Department of health and NHSE vision for integrated, easily accessible and responsive services which deliver the right level of care to meet local need. The three guiding principles are:

·       Self-care and prevention

·       Right care, first time

·       Easy to navigate with consistent offer

 

Each work stream would have a clinical lead. The programme was underpinned by the Enhanced Primary Care offer (EPCC) whose approach was holistic with multi-disciplinary teams working collaboratively and building trust. One call centre would service the whole STP area. Urgent Treatment Centres (UTCs) would be made available across Staffordshire, each to provide diagnostics, be open a minimum of 12 hours each day and support ‘walk-in’ presentation. UTCs are mandatory but would have some discretion to address local need. Furthermore, extensive series of internal changes to the local Emergency Department and improvements to discharges from the acute trust bed base were proposed.

 

The Programme had set clear targets, the outcome of which would be to release monies back into the health economy. In particular, A&E attendance should be reduced by 30%; emergency admission by 23%; emergency admission by frail or elderly with long term conditions by 30% and the four hour wait in A&E to be achieved in four hours. The Staffordshire region had failed to meet its target on delayed transfers of care (DToC) and hoped to be back on track by September. A stable work force was crucial.

 

Winter planning formed a key part of the overarching UEC operational plan, which covered all actions required to deliver the vision. A Member asked when the Regulators required the Winter Plan to be published.

 

Ms Scullion said that the first draft would be with the A&E Board by June and could be made available to the Select Committee. Mr Wade assured Members that for the first time, clinicians had been involved with the preparation of the Winter Plan.

 

A Member asked a question about UTCs in Lichfield and the population to be reached. Ms Scullion explained that the UTCs were not necessarily co-terminus with District boundaries. 

 

A Member felt there was very little reference to the Ambulance Service yet they play a key role in UEC. Mr Whitehouse agreed that the Ambulance Service was a key partner and actively involved in supporting and integral to delivery of winter planning. The Ambulance Service needed to be responsive and fully integrated and paramedics need to be highly skilled and aware of all options. Members were reminded that the Scrutiny Committee would receive presentations relating to  ...  view the full minutes text for item 5.

6.

Healthy Staffordshire Select Committee Work Programme 2018/19 pdf icon PDF 257 KB

Report of the Scrutiny and Support Manager

Minutes:

The Scrutiny Manager outlined some proposed changes to the work programme for 2018-19, namely the inclusion of the following matters for pre-decision scrutiny:

·         Adult learning disabilities and roll out of CPP

·         Modernising social care pathway

·         Modernising adult social care - blue print and business case. 

 

RESOLVED That the Work Programme 2018-19 be amended to include additional items for pre-decision scrutiny.