Agenda and minutes

Please see note (a) at the end of the agenda.

No additional declarations were made.

The committee is required to debate motion 780 (Accident and Emergency Waiting Times) carried at the meeting of council on 14 September 2016, and report the outcome of its debate to the meeting of council on 15 February 2017.

The motion refers to the decision taken in 2013. To place this debate within the context of the NHS Five Year Forward View and the new models of care for emergency and urgent care services and what this means for Gloucestershire, the committee will receive a presentation from the Associate Director of Commissioning, Gloucestershire Clinical Commissioning Group.

Motion 780 – Accident and Emergency Waiting Times

This Council notes the recent decision by NHS Improvement to find Gloucestershire Hospitals NHS Trust in breach of its licence, as a result of a consistent failure to meet Accident and Emergency waiting times.

This Council further notes the decision, taken in 2013, to downgrade Cheltenham Accident and Emergency Department at night, attributed to a shortage of specialist doctors.

This Council calls on the Health and Care Scrutiny Committee to urgently review this situation, and in particular clarifying:

a) What role the night-time downgrading of Cheltenham Accident and Emergency may have played.

b) Whether its reopening could help solve the situation

c) Whether the Gloucestershire Hospitals NHS Trust and Gloucestershire Clinical Commissioning Group are committed to fully reopening Cheltenham A&E through continuing to seek to recruit the necessary specialist doctors.

64.1    Cllr Tim Harman proposer of the original motion addressed the committee to provide context to the discussion. He emphasised that it was an important issue as set out within the papers. He expressed his personal concern about the impact of the downgrading of Cheltenham A & E. He read the three parts of the motion:

a)    What role the night-time downgrading of Cheltenham Accident and Emergency may have played.

b)    Whether its reopening could help solve the situation

c)   Whether the Gloucestershire Hospitals NHS Trust and Gloucestershire Clinical Commissioning Group are committed to fully reopening Cheltenham A&E through continuing to seek to recruit the necessary specialist doctors.

He explained that he had spoken to members of the public and organisations who had concerns about the overnight position at Cheltenham General Hospital. He recognised that since the motion had been put forward, there had been developments regarding the Trust and the Sustainability and Transformation Plan (STP). He looked forward to hearing more regarding Clinical Commissioning Hubs and Urgent Care. He stated that despite this, the Cheltenham A&E was essential for public confidence.

64.2    Mary Hutton, Accountable Officer GCCG and Dr Andy Seymour Clinical Chair GCCG, provided the committee with a presentation to place the discussion in the context of the NHS Five Year Forward View and the local STP and the new models of care for emergency and urgent care services.

Context: Focus on Urgent and Emergency Care

64.3    It was explained that engagement regarding the local STP was currently underway. The STP set out a direction for managing care with changes in population and health and care needs  over a number of years. There would be an increasing number of people with long term conditions and without transforming the way local services are delivered there was potentially a gap of £226m over the four years.

64.4    The Committee understood the ‘One place, one budget, one system’ approach where it was believed that wherever possible care should be provided in the person’s own home, in the GP surgery or in the community. Where people had more serious illness or injury, they should receive treatment in centres with the right facilities to maximise chances of survival and recovery.

64.5    The Committee was provided with some case studies of the issues within the current system. An example was given of an individual with neurological needs not being able to access the specialist advice he needed. 

64.6    Members were informed that the vision for urgent care was the right advice and treatment in the right place, first time. There were four key outcomes:

•      People are better supported to self care and remain more independent  and be less reliant on health and social care services

•      The overall system is more than the sum of its parts through the ‘place based’ connection of relevant urgent, emergency, other appropriate care services, voluntary and community organisations and communities themselves

•      Less people need Emergency Departments, due to highly responsive urgent care services outside  ...  view the full minutes text for item 64.