Agenda and minutes

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

Cllr Stephen Hirst declared a personal interest as a Chair of Tetbury Hospital.

Cllr Stephen Andrews declared a personal interest as a Community First Responder with the South Western Ambulance Service NHS Foundation Trust.

Cllr Steve Harvey declared a personal interest as his wife is employed by NHS England.

2.1       The minutes of the meeting held on Tuesday 14 November 2017 were agreed as a correct record and signed by the Chairman.

2.2       The Chairman took the opportunity to thank Ruth FitzJohn, who had recently retired as Chair of the 2Gether NHS Foundation Trust, and Dr Sally Pearson, who was retiring from her post as Director of Clinical Strategy at the Gloucestershire Hospitals NHS Foundation Trust at the end of this month, for their work with the committee and for the people of Gloucestershire and to wish them well for the future.

This report was published at 10.00am on Monday 8 January 2018..

The committee to also receive a presentation.

3.1       The committee received a detailed presentation on the outcome of the consultation on this matter from the Associate Director Engagement and Experience Gloucestershire Clinical Commissioning Group (GCCG), and the Chief Executive Gloucestershire Care Services NHS Trust (GCS). (For information the presentation slides were uploaded to the council’s website and included in the Minute Book.)

3.2       The presentation included detail on the number of respondents, the quantitative and qualitative data, the main themes from the responses, and the demographic information of the respondents. The Chief Executive, GCS, informed the committee of the NHS response to the consultation outcome and the next steps for both the GCS and GCCG Boards.

3.3       The committee’s role in this stage of the development of community hospitals in the Forest of Dean was to confirm whether or not it was satisfied that the consultation process was appropriate, gave sufficient engagement opportunities for local communities; and to agree whether there were particular issues that it would wish the GCCG and GCS Boards to consider when they meet to agree the way forward later this month.

3.4       The committee engaged in a detailed debate on this matter. The main comments/questions/concerns related to:-

Ø  The number of respondents to the consultation when compared to the population size

It was explained that although the response rate, 3344 questionnaires received, might seem low in comparison to the 85k population, this number was statistically significant. It was further explained that the number required for this to be statistically significant was a sample size of 383. It was also important to note that the GCCG and GCS had also undertaken a lot of work with town and parish councils alongside the survey.

Ø  A lack of clarity relating to the citizen’s jury process

The committee was informed that GCS wanted this to be a neutral process. Membership would be drawn from a cross section of representatives from health, social care and the community. There would be opportunities for lobby groups to give evidence, but they would not be members of the panel.

Ø  The lack of a specific location had impacted on people’s responses

It was acknowledged that this had been an issue for many of the survey respondents and had impacted on how they chose to respond. The Chief Executive, GCS, was clear that a specific site had not been identified as yet, and that there was still much to work through and consider before a final decision could be made. This would be guided and informed by the Citizen’s Jury.

Ø  How did this proposal relate to the aims of the STP

The committee was informed that this proposal did reflect the direction of travel identified in the STP.

Ø  There needed to be greater clarity/evidence for the number of beds, particularly given housing developments (and the impact of the removal of tolls from the Severn Bridge)

The Chief Executive, GCS, informed committee members that this had been a clear message through the consultation, and that GCS  ...  view the full minutes text for item 3.

4.1       Paul Birkett-Wendes, Head of Operations North Division, updated the committee on the Ambulance Response Programme (ARP), in particular the new ambulance response standards. He reminded the committee that the Trust had been part of the initial pilot of the ARP. He informed the committee that the Trust has seen improvements in productivity and efficiency, from the initial pilot, with, on average, less vehicles being sent to each incident, therefore freeing up resources to attend more patients.

4.2       Five committee members had recently visited the Trust’s Clinical Hub at Bradley Stoke. These members informed the committee that they had been impressed with the professionalism of the emergency call handlers and clinicians. They had also been impressed with the resilience measures that had been built into the design of the building. It was noted that these measures had recently proved their worth when there had been a power outage at the Trust’s Exeter hub. It was explained that additional measures have now been put in place at Exeter. It was agreed that the committee would receive the outcome report from the official investigation into this matter.

ACTION:        SWASFT

4.3       In response to a question relating to the workforce the committee was informed that the situation in Gloucestershire was better than in Somerset and Devon. The Trust worked well with the universities. The Trust also had high see and treat rates which made it an attractive place to work. It was noted that some GP practices were now recruiting Paramedics and this would have an impact on the available workforce. However it was also explained that some Paramedics were choosing to work in both organisations.

4.4       The committee was also informed that over the New Year period the Trust had trialled sending Community First responders (CFRs) to respond to falls. This had worked well with positive feedback from patients being received.

5.1       The committee was pleased to hear from the Deputy Director Adult Social Care that he had taken steps to get the reporting timeline for these reports to be in line with other performance reports.

5.2       The Deputy Director informed the committee that the use of residential care had stabilised in this quarter. The committee reiterated its concerns with regard to performance against targets related to the reassessment of needs. Members were informed of the activity that was in place to address these issues and the challenges around how these metrics were measured. It was agreed that more detail on this work would be included in the performance report to be received by the committee in March 2018.

5.3       It was commented that the council could be justifiably proud of its performance with regard to the employment of people with a learning disability. It was however questioned why the 2015/16 was the last reported year for ASCOF 1E Adults with Learning Disabilities in Employment. This information was not available at the meeting; an answer would be sent to members following the meeting.

ACTION:        Mark Branton

6.1       It was questioned what progress there has been with regard to One Place, One Budget, One System. The STP Lead explained that this approach was being taken through the clusters in the first instance; focussing on developing this from the ground up; working across the health and social care sectors. There was a governance structure to support this through the Joint Commissioning Partnership Executive (JCPE) and Joint Commissioning Partnership Board (JCPB). There was a view that this did not appear to represent a one budget approach. The STP Lead informed the committee that she would be happy to present to the committee on the work in place to deliver integrated services at a future meeting if the committee so wished.

The committee noted the report.

8.1       The committee noted the drug and alcohol referrals through the Gloucestershire Safeguarding Children’s Board (GSCB), and were interested, given the demographics of the county, that there were twice as many referrals from the Stroud area than Cheltenham.

ACTION:        Sarah Scott

9.1       Having received an item on winter planning at its meeting on 14 November 2017 the committee questioned whether this was proving to be effective. Members were informed that it has been challenging, particularly between Christmas and New Year, but in terms of planning this was the most robust winter so far for Gloucestershire. The Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) informed members that the Trust was the last in the region to escalate to level 4, and were back to level 2 in 2 days. The 4 hour A & E standard had been met in November 2017, and this continued into December 2017, had had no 12 hour A&E breaches in contrast to other systems in the region and GHNHSFT had had the best ambulance handover times in the region.

9.2       Members were aware that NHS England had issued guidance for the cancellation of all non-urgent operations, and questioned whether this directive had been implemented in Gloucestershire. The committee was informed that GHNHSFT had been allowed to apply local discretion due to their improved performance in the run up to Christmas and had therefore continued to perform routine operations though not to usual levels; out-patient clinics had also continued where they did not impact on urgent and emergency care. The committee was also informed that GHNHSFT was also the only major centre undertaking trauma and orthopaedic operations on 2 January 2018 following recent changes to the model of care between its two sites.

9.3       It was acknowledged that there was a high level of interest locally and nationally with regard to the ‘flu virus. It was agreed that an update on this matter be circulated to committee members following the meeting.

ACTION:        Sarah Scott