Agenda and minutes

Councillor Ann Edgeller declared an interest as Staffordshire County Councils appointed Partner Governor at the Midlands Partnership Foundation Trust (MPFT).

Councillor Bernard Peters declared an interest as Staffordshire County Councils Local Authority appointed Governor at University Hospital Derby and Burton (UHDB).

Resolved – That the minutes of the meeting held on 13 November 2023 be confirmed and signed by the Chairman.

The Committee were advised that the Chairman of Safeguarding Overview & Scrutiny Committee, Councillor Bob Spencer and the Vice-Chair, Councillor Gill Burnett-Faulkner attended the Committee meeting on 31 July 2023, however this was not reported in the minutes.

Resolved – That the Committee note the omission of Councillor Bob Spencer and Councillor Gill Burnett-Faulkner in the minutes of the meeting held 31 July 2023.

Report of the Staffordshire and Stoke-on-Trent ICB.

Helen Slater, Associate Director for Transformation at Staffordshire and Stoke-on-Trent ICB and Karen McGowan, Associate Director Nursing, Quality & Maternity at Staffordshire and Stoke-on-Trent ICB presented the Maternity and Neonatal Services Update to the Committee.

The Committee noted the following comments and responses to questions:

·         Assurance was given that there was a Patient Safety Specialist officer in place as per the Ockenden report.

·         Freedom to speak up policies across the ICS were being refreshed. Assurance was given that the providers within Staffordshire were ensuring that there were robust speak up processes in place.

·         The Freestanding Midwife-led Birthing Units (FMBU) at County Hospital and Samuel Johnson Community Hospital were suspended at the beginning of the pandemic in line with national guidance. It was reported that significant staffing challenges had prevented these units to reopen safely. The ICB had worked with UHNM and UHDB to outline the current position of FMBUs and had presented a case for change to NHSE and they supported the proposal to continue with an options appraisal process and public engagement regarding the birthing services at County Hospital and Samuel Johnson.

·         Prior to the temporary closure of the FSBUs, the number of women choosing to give birth there remained low. In 2019/20, 94 women gave birth at County Hospital and 220 women gave birth at Samuel Johnson Community Hospital. It was reported that these numbers were significantly below the 350 births per unit per year recommended in 2018 for the FMBUs to be clinically and financially viable.

·         A draft Communications and Engagement plan setting out the Public Engagement activities over the next few months had been shared with the Staffordshire and Stoke-on-Trent People and Communities Assembly and ICB Quality & Safety Committee and feedback would be incorporated into the business case.

·         Home birthing services were also suspended during the pandemic and had subsequently been restored and were currently paused due to workforce challenges. It was reported that the ICB received regular updates in relation to the anticipated reintroduction of these birthing services within Q4 2023/24.

·         Staffordshire and Stoke-on-Trent had the second highest neonatal mortality rate in the UK. The UHNM Neonatal Improvement Group had been re-established to better understand the data and identify areas for learning. It was also reported that the Children and Young People Programme Board had commissioned an Infant Mortality review and a steering group had been established to look into the wider social factors which may impact on neonatal mortality rates.

·         A full route cause analysis is completed for every neonatal death.

·         Following a CQC visit to UHNM Maternity Services in March 2023, a S29a notice was issued with further actions included in the final report. The Trust’s response to these actions was overseen by the ICB and NHSE.

·         The Committee discussed that SSOT ICB should investigate the feasibility of an external audit of maternity services in Staffordshire.

·         There had recently been successful recruitment campaigns in both UHNM and UHDB to reduce the vacancy rate. The Committee were informed that initially the influx of new recruits  ...  view the full minutes text for item 48.

Report of the Staffordshire and Stoke-on-Trent ICB.

Paul Brown, Chief Finance Officer presented the Staffordshire and Stoke-on-Trent ICB Performance and Finance Overview to the Committee. The Committee were presented with a headlines and escalations summary.

An overview of key underpinning deliverables was also shared with the Committee:

·         Children and Young People/ Maternity

·         Planned Care, Diagnosis & Cancer

·         Improving Population Health

·         Urgent and Emergency Care

·         Mental Health, Learning Disability and Autism

·         Primary Care

·         End of Life, LTCS and Frailty

The Committee noted the following comments and responses to questions:

·         The ICB recognised the value of Patient Participation Groups which regularly provided information to the ICB on General Practices. The ICB offered to support General Practices to establish a Patient Participation Group.

·         As per the Mental Health Investment Standard, a greater share of resources had gone into Mental Health Services.

·         There were some key underpinning deliverables were behind plan with no mitigations identified to improve the position in year. The Committee were advised that some of the deliverables were unachievable, a reason for this, highlighted to Committee, was due to lack of resource and industrial action.

·         The Committee raised concerns around the CAHMS waiting list and requested to receive a briefing note detailing the actions to address the issues.

·         At month 6 the ICB was reported a year-to-date deficit position of £66.4m. This was due to CHC inflation and volume challenges, inflation in excess of plan in primary care prescribing and efficiency under-delivery. It was reported that the system had delivered £75.2m of efficiency as of September 2023.

·         The Committee discussed the prevention agenda and the role of partners in reducing the number of people needing to access health services.

·         The priority of deliverables within the report was not clear. The Committee requested that this be highlighted in future reports.

·         Assurance was given that services were safe and continuing whilst development was ongoing.

Resolved – That (a) the report be received and, the Committee comments be noted.

(b) the Committee receive a briefing note detailing the actions to address the CAHMS waiting list.

The Committee received the District and Borough Health Scrutiny activity update report.

Resolved – That the District and Borough Health Scrutiny activity update report be received and noted.

The Committee agreed to add a review of the acute trusts for next years’ Work Programme.

Resolved – That the Work Programme be updated and noted.