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 minutes of the meeting held on 11 April 2022 be approved and signed as a correct record.

Report of the Staffordshire and Stoke-on-Trent Integrated Care System (ICS)

The Planned Care Lead for Staffordshire and SoT ICS and Chief Operating Officer UHNM were in attendance to provide an update report in respect of Elective Recovery across the three main provider organisations that serve Staffordshire and SoT, namely  University Hospital of North Midlands (UHNM), University Hospital Derby and Burton (UHDB), and the Royal Wolverhampton Trust (RWT).

Members noted that although significantly reduced, the number of Covid patients in hospitals beds continued to put pressure on the Trusts. The report outlined actions that were planned in respect of elective recovery endeavours to reduce waiting for an elective procedure, the approach as an Integrated Care System (ICS) with regard to elective recovery and an update on Cancer Service performance for the three providers as of April 2022.

Committee noted that:

• The first milestone was to eliminate the number of patients waiting 104 weeks by the end of June 2022 and 78 week waits by March 2023. Patients were waiting for complex surgery and more specialist services. Limited workforce was a challenge, particularly theatre staff, there was more flexibility with surgical staff.
• The aim was to reduce the waiting period to 18 weeks, where it had been pre-pandemic. Members suggested that an ambition for zero waiting time would be ideal, but recognised it was unlikely. Hospital Trusts were working closely with independent sector to reduce waiting times, the NHS had always worked with the independent sector and would continue to do so.
• Backlog had built up during the first wave of Covid when apart from cancer and critical surgeries many surgeries were ceased or slowed.The challenge of treating patients who had been waiting was acknowledged, conditions had progressed. There was a growing number of urgent surgeries and a reduced number of less urgent longer waits.
• Members were assured that all theatres were currently operating at 100% and new theatres were planned.
• Progress on addressing the backlog :
  • RWT was on track, it was geographically well placed and was well supported by other Black Country NHS Trusts.
  • UHNM secured some support with bariatric patients from Worcester area. UHDB was struggling with bariatric patient treatment
  • County Hospital was trying to ensure a range of procedures at hospital day surgery in the local area,  major surgery would be dealt with elsewhere.
  • Cannock Hospital -Two further theatres were operational to focus on a broader range of procedures
  • Burton hospital had also invested in additional theatre space.
• Approach to elective recovery three areas:

1.   Demand management- alternatives to referral/ fit for surgery

2.   Existing capacity best use - NHS and independent sector

3.   New capacity at sites.

• Members noted that health inequalities had broadened over the course of the pandemic and that information to inform services was being evaluated.
• Patient choice – some patients had declined a date offered if it did not suit their own circumstance. Members were assured that those patients would not go to the ‘back of the queue’ and that patients would be managed both on urgency and time they have  ...  view the full minutes text for item 3.

A presentation from the Director of Health and Care detailing changes to the Healthy Communities Service from April 2023 will be provided at the meeting.

The Lead Commissioner Public Health and Prevention provided a report and presentation about proposals for the integrated lifestyle services from April 2023.

Committee was advised that the service contract had focussed on residents with most need in 148 super output areas, for a range of issues:

• weight management
• physical activity
• stop smoking
• social isolation prevention
• falls prevention
• NHS health checks

The services were reported to be good overall and had surpassed outcome targets in all areas, but the take up of services had been low due to the eligibility criteria which had made access restrictive. A third of adults in Staffordshire were classed as overweight or obese and additional Government funding for weight management last year had enabled the eligibility criteria to be opened up to anyone over 18 years which had increased take up.

Other programmes and initiatives such as the Supportive Communities Programme and Better Health Staffordshire had been developed. Communities and the voluntary sector provided support for physical activities, fall prevention and social isolation prevention. Public Health has also developed a Mental Wellbeing Programme and a range of self-help approaches including APPs and use of social media to reach out to members of the public. The range of support in communities provides opportunity for the Healthy Community Services to focus on fewer issues, therefore increase funding for the key priorities. It can remove the eligibility restrictions to make access to services easier.

The Lead commissioner advised that proposals stemmed from recent consultation. He outlined the proposals for the new contract from April 2023 and invited members to consider what was the most effective and efficient use of resource.

Committee noted the following comments and responses to questions:

·       A key issue was the eligibility criteria which had impacted on take up of some services. Members welcomed the removal of the eligibility criteria, the focus on fewer intervention activities, and considering the alternative approaches available to address the issues.

·       Members endorsed the ‘less is more ethos’ moving forward, the need to reserve services for those that need them most and find alternative ways to promote services for all through other programmes, to achieve outcomes.

·       There was concern that the weight management programme had not reached the people it needed to. Members were assured that in addition to doctor referrals community engagement officers were promoting the service and reaching out to people in the community to build the message and increase referrals to services from other sources. Many referrals were self-referrals from social media and campaigns.

·       In terms of funding allocated to each service it was questioned if there had been a cost benefit analysis of smoking cessation services in terms of preventing hospital spend due to people quitting smoking. Members were assured that smoking cessation services had been very well evaluated and were cost effective locally and nationally.

·       The cost of services: £500k in targeted weight management (approx. 50%) and non-targeted, £800k stop smoking services and £200k for targeted NHS health checks.

·       It was noted that there was separate  ...  view the full minutes text for item 4.

Report of the District and Borough Representatives

The Chairman advised that officers were reviewing the Joint Codebetween County and District Councils to reflect the way of working in health scrutiny.

District and Borough representatives presented update reports and highlighted the following matters being considered at District and Borough meetings.

• The Lichfield District Representative raised an issue relating to maternity services and the temporary closure of Samuel Johnson Hospital in Lichfield, he advised that some facilities in Burton Maternity Unit were also temporarily closed. He requested an update report relating to the re-opening of the unit at Samuel Johnson Hospital. The Chairman advised that the Transformation of Maternity Services would be considered at a meeting on 11 July 2022.
• The Cannock Chase District Representative Cllr Philippa Haden would be invited to attend a briefing relating to the Cannock Minor Injuries Unit MIU.

Resolved:

1. That the District and Borough Updates be noted.

Report of the Scrutiny and Support Officer

The Chairman introduced the draft work programme item and indicated that planning the work programme was an opportunity to prioritise and focus on what items to consider through the year.

The Chairman highlighted the need for the Committee to develop a formal way of scrutinising issues. For example - look in depth at issues based on the risk to residents or auditing the processes that the NHS go through in relation to a patient’s journey. He highlighted the importance of challenge, if the committee had done enough detailed scrutiny to be assured by evidence provided and responses given.

The Chairman advised that a framework for Health Scrutiny was being developed which he would share for comments. Committee members would use the framework when prioritising topics, focussing on the issues, and developing lines of enquiry.

Members considered the draft Work Programme and suggested items for inclusion of the work programme 2022-23.

• Dental Health – Focus on access to NHS dentistry
• Health Visitor Service – Current service position
• West Midlands Ambulance Service – Public concerns about service. System problems and impact on WMAS
• Women’s Health – The breadth of matters to be covered necessary to establish a working group to agree key lines of enquiry. Members appointed – Councillors Janice Sylvester Hall, Patricia Ackroyd, Barbara Hughes, and Ann Edgeller.
• Innovation - The Chairman suggested the Committee ask Staffordshire University to host an innovation day to invite suppliers to present innovations to improve patient and partners journey and invite partners to attend.
• NHS Visual Impairment Services – Good practice in District and Boroughs
• Thinking healthier in all we do  - Wider Determinants

Members identified areas:

Wider determinants workshop on 21 June 2022 at 2pm.

·       Mental Health Strategy – awaiting timelines for the report to be released.

Next meetingof the Health and Care Committee takes place on 11 July 2022. Items on the agenda:

• ICS & ICB update
• Primary Care update
• Transformation Programme – maternity services

Resolved

1.   That the matters identified be included in the Health and Care Overview and Scrutiny Work Programme 2022-23