Agenda and minutes

To verify the meeting is quorate (six Members required)

The Chairman verified that the meeting was quorate.

Councillor Jones declared an interest in all matters included on the Agenda relating to NHS hearing aids owing to his daughter being in receipt of a hearing aid.

Councillor Peters declared an interest in all matters included on the Agenda relating to University Hospitals of Derby and Burton NHS Foundation Trust owing to his membership of their Council of Governors.   

RESOLVED – That, subject to the substitution of first sentence of the sixth paragraph on page four of the minutes by:-

“A member expressed concern about recent press reports regarding the suspension of services to cancer patients”,

the minutes of the meeting held on 10 August 2020 be confirmed and signed by the Chairman.

Joint report/presentation of Staffordshire Secondary Care NHS Providers, Clinical Commissioning Groups and Staffordshire County Council  

The Committee considered a joint PowerPoint presentation/report (slides attached at Appendix A to the signed minutes) by the Chief Executive of University Hospitals of North Midlands NHS Trust (UHNM), Chief Executive Officer of University Hospitals of Derby and Burton Foundation Trust (UHDB), Chief Executive of Royal Wolverhampton NHS Trust (RWT), Chief Executive of Midlands Partnership Foundation Trust (MPFT), Accountable Officer of Staffordshire Clinical Commissioning Groups (CCGs), Cabinet Member for Health, Care and Wellbeing, Staffordshire County Council (SCC) regarding the impact of the 2020 Covid-19 pandemic on each organisation’s Winter Plans for the 2020/21 season.

Paul Bytheway (Chief Operating Officer), UHNM; Duncan Bedford (Executive Managing Director), UHDB; David Loughton (Chief Executive), RWT; Jennie Collier (Managing Director, Staffordshire and Stoke-on-Trent Care Group) MPFT; Marcus Warnes (Accountable Officer), Staffordshire CCGs; Johnny McMahon (Cabinet Member for Health, Care and Wellbeing) SCC and; Simon Whitehouse (Director), Together we’re Better (Sustainability and Transformation Partnership (STP) for Staffordshire) were present at the meeting.

All NHS secondary care trusts were required to produce Winter Plans aimed at ensuring services were configured towards:- (i) preparedness; (ii) prevention and; (iii) protection of the local population against the major avoidable ill-effects of winter on health. Members had previously expressed serious concern over the additional pressures likely to be experienced by Trusts during the 2020/21 season owing to a surge in demand exacerbated by the Pandemic.

The presentation slides circulated to the Committee in advance of the meeting gave detailed information regarding:- (i) Phase Three National Restoration and Recovery Priorities; (ii) Restoration and Recovery: Waiting Lists Update; (iii) Assumptions this Winter informed by Data relating to Accident and Emergency Attendances, Primary Care Appointments, NHS 111 Analysis; (iv) Areas of Focus; (v) Mental Health; (vi) Planning for Covid-19 Surges; (vii) Communications and Engagement; (viii) Risks and Mitigations; (ix) National Discharge Service: Policy and Operating Model; (x) Discharge Pathways – System Success; (xi) additional submitted Trust specific information.

Following an introduction from the Director, Together We’re Better in which he referred to the uncertainty surrounding the future of the outbreak and emphasised Health and Care’s overwhelming priority to keep people safe by:- (i) reducing the length of time spent in hospital; (ii) preventing admissions; (iii) increasing community capacity; (iv) supporting care homes; (v) working collaboratively and; (vi) implementing the enhanced NHS flu-vaccination programme, Members scrutinised and held the organisations to account over the scope, timeliness and details of their Plans, asking questions and seeking clarification where necessary.

In response to requests for clarification regarding support for care homes, recruitment of General Practitioners (GPs) and mental health service provision, the Managing Director, MPFT referred to joint working already undertaken with the County Council to provide additional targeted support to Staffordshire Care Homes at the start of the pandemic which would continue throughout the winter and through the recovery phase. Hospital Trusts were receiving additional funding to support existing discharge models aimed at reducing the length of admissions and mental health services were being bolstered through additional investment identified in the Long-Term Plan. The  ...  view the full minutes text for item 25.

Report/presentation of Accountable Officer, Staffordshire Clinical Commissioning Groups

The Committee considered a report (Appendix B to the signed minutes) of Staffordshire Clinical Commissioning Group’s (CCG) Accountable Officer regarding future NHS Hearing Aid provision in Staffordshire.

In 2015, following a consultation and engagement process, North Staffordshire CCG adopted a revised commissioning policy which included new eligibility criteria for NHS funded hearing aids for adults with hearing loss. The policy, which was implemented on 1 October 2015, provided that patients (aged 18 years and above) with moderate hearing loss (41-55 decibels) whose everyday lives was affected by their disability, were eligible to receive an NHS funded hearing aid. However, patients with a mild hearing loss (less than 41 decibels) were not now eligible for funding and would not receive a hearing aid. Those patients with a hearing loss of 56 decibels or more were unaffected by the changes together with those who already had an NHS hearing aid for the duration of their three-year pathway at which point they would be re-assessed.

The provision of hearings aids throughout Staffordshire and Stoke-on-Trent was reviewed in 2019 following the release of:- (i) the findings of a Cochrane review in 2017; (i) publication of NICE Guideline NG98 - Hearing Loss in Adults: Assessment. After consideration of relevant clinical evidence, all six Staffordshire and Stoke-on-Trent CCGs agreed to undertake a formal consultation (‘Difficult Decisions’) on a number of areas which included the provision of hearings aids for non-complex needs. An initial informal consultation commenced in January 2020 to gather views of patients, the public and other interested stakeholders so that various consultation options could be devloped. However, further work had been placed on hold owing to the outbreak of the Covid-19 pandemic and it was not yet clear when this would re-commence having regard to the effect of the pandemic on the CCGs priorities and ability to undertake face to face engagement, safely.

In response to questions from a Member regarding (i) the cost savings/cost effectiveness achieved by North Staffordshire CCG since implementing their revised hearing aid policy in 2015 and; (ii) the results of the informal consultation undertaken from January to March 2020, the Accountable Officer said that he would refer back to the committee with this information, as soon as possible. In response to a further question regarding the impact of the decision on those people with mild to moderate hearing loss who had become ineligible to receive NHS hearing aids under the revised policy, particularly in light of the Covid-19 pandemic, the Accountable officer assured the Committee that the formal consultation and any further policy changes would take account of such matters, at the appropriate time.

Continuing, the Member expressed her serious concerns over the impact of the 2015 policy decision and an apparent lack of evidence-based commissioning by the CCG.

Another Member referred to the importance of undertaking an extensive and meaningful consultation process to include the public/service users etc. at the appropriate time. 

RESOLVED – (a) That the report be received and noted.

(b) That details of cost savings/cost  ...  view the full minutes text for item 26.

Reports/oral reports of District/Borough Councils’ Representatives

The Committee considered a report (Appendix C to the signed minutes) of the Scrutiny and Support Manager giving a summary of the health scrutiny activity which had been undertaken by Staffordshire District and Borough Councils under the standing joint working arrangements, since their previous meeting.

During the discussion which ensued the Chairman asked Members whether the District/Borough Council’s Committees/Panels had yet engaged with local Outbreak Control Boards and received presentations on the epidemiology for Covid-19 and responses in their areas to local outbreaks. Members of the Stafford and Newcastle-under-Lyme Boroughs Committees/Panels confirmed that they had. In addition, a Member of South Staffordshire District Council expressed the appreciation of her Authority for the information shared by the County Council in this respect.

RESOLVED – That the reports and further updates as set out above be received and noted.

Report of Scrutiny and Support Manager

The Committee considered a rolling Work Programme for 2020/21 (Appendix D to the signed minutes).

The Director of Corporate Services highlighted the outcome of the informal meeting between the Chairman, Vice-Chairmen, Cabinet Member for Health Care and Wellbeing and Director of Health and Care on 28 August 2020, ie the inclusion of:- (i) Items for 26 October 2020 meeting – Social Care Green Papers (National and Staffordshire) and Learning Disability Services (Day and Respite Care); (ii) Items for 30 November 2020 meeting – Community First Responders (Update) and Digital Exclusion; (iii) Inquiry Day (date to be confirmed) - Wider Determinants of Health (to include tackling obesity); (iv) Items for 1 February 2021 meeting – Care Homes (Future Demand and Critical Issues).

In addition, (i) the Cabinet Member for Health, Care and Wellbeing had given notice of pre-decision scrutiny required in early 2021 on the Authority’s new Mental Health Strategy and; (ii) Staffordshire and Stoke-on-Trent Clinical Commissioning Group’s (CCG) Accountable Officer had requested scrutiny of the new Integrated Care Partnership during November/December, proposed dates for which would be included in their Work Programme when further details were known.

The Director also highlighted an invitation received from the Safe and Strong Communities Select Committee to attend their meeting on Tuesday 13 October 2020 at 10.00 am in connection with the Staffordshire Children’s’ Transformation Plan.

During the discussion which ensued, the Chairman proposed that:- (i) the Committee give further consideration to NHS Hearing Aid provision in Staffordshire at their February 2021 meeting, subject to sufficient progress being made by the CCGs and; (ii) they give consideration to the adoption of a dashboard of metrics relating to Health, Care and Wellbeing in order to assist them in identifying issues of concern, at their next meeting.

A Member cited ‘Long-Covid’ as a topic for scrutiny at further meeting.

RESOLVED – (a) That the report be received and noted.

(b) That the Chairman in consultation with the Vice-Chairman and Shadow Vice-Chairman agree a date for the Committee to consider ‘Long-Covid’.

(c) That the Work Programme 2020/21 be updated to include the above-mentioned additional matters.

(d) That the updated Work Programme 2020/21 be brought to their next meeting for approval.

RESOLVED – That the date time and venue of the next meeting be noted.