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.

Cllr Carole Allaway Martin declared a personal interest as she is a member of the Royal College of Nursing.

The minutes of the meeting held on Tuesday 9 January 2018 were agreed as a correct record and signed by the Chairman.

12.1     This matter would have been reported to the committee at its meeting in May 2018. In response to a request from some committee members, who had concerns with regard to this matter, at the discretion of the Chairman this was instead included on the agenda as a late item.

12.2     In response to a request from the Chairman of the committee the Chief Executive of GHNHSFT had submitted a detailed briefing to the committee including; the reasons for and development of the proposal to establish a SubCo, the type and number of staff affected and the staff consultation process. The proposal did not include clinical staff.

12.3     In response to questions the CEO explained that GHNHSFT had looked carefully at models used in other NHS Trusts and had proceeded with SubCo because the Board felt it was most likely to address the challenges facing the service, secure many of the benefits associated with private sector companies but most importantly would be wholly owned by the NHS Trust. In response to the suggestion that the model would create a two tier service she explained there were already examples of the current workforce being on different terms and conditions, for example, there were already three iterations of the NHS pension scheme in place and  equal pay legislation required GHNHSFT to ensure that staff doing the same, or very similar jobs, were remunerated to the same level. It was also clarified that the petition (900 signatories) that had been referred to in the local media was a national, not local, petition; and that this SubCo would be fully accountable to Her Majesty’s Revenue and Customs (HMRC) as required.

12.4     Some committee members, whilst acknowledging that there has been formal consultation with affected staff members, felt that the HCOSC should also have been consulted. However this matter relates to how GHNHSFT organises its workforce, not to a service change and therefore does not fall within the remit of the committee, nor would there be a requirement for GHNHSFT to consult the committee. It was commented that information on the committee’s position with regard to this proposal had been sent to committee members on 2 January 2018.

The committee to receive a presentation and the Winter Plan document. These will be sent To Follow.

13.1     At the November 2017 committee meeting the Gloucestershire Winter Resilience Plan was received and discussed. It was therefore important to understand whether the objectives identified in the plan had been achieved. The committee was pleased to welcome representatives from across all partners (NHS, Public Health and Social Care) to the meeting to discuss this matter with committee members. The Winter Plan document and the detailed presentation received at the committee meeting described the breadth of activity and schemes involved; these were available on the council’s website.

13.2     It was clear that despite the challenges a lot had been achieved; attributed to significantly closer partnership working, and to every member of staff working together to achieve the best for patients. Headlines from this period included:-

Ø    Significantly improved winter ED (Emergency Department) performance – the national 4 hour standard was met in November 2017 (the first time in 4.5 years); December 2017 saw an increase in performance of 16.84%, and January 2018 a 15.01% improvement in comparison with the same time period in the previous year;

Ø    A 78% reduction in ambulance handover delays, with zero over one hour;

Ø    59% increase in weekend discharges;

Ø    Reduced delayed transfers of care (DTOC) with Gloucestershire being the third best in the country for January 2018;

Ø    The (Gloucestershire Care Services NHS Trust) rapid response service supported 80% (1295) more patients to remain in their own home this winter compared to last year;

Ø    CareUK’s south west 111 service maintained a strong and consistent clinical service across the winter period; and were able to rapidly deploy a dedicated A & E revalidation line specifically to assist with system challenges within the GHNHSFT.

13.3     It was also reported that there had been unprecedented demand on the Ambulance Service, particularly on New Years Day; that flu preparedness across the system had worked exceedingly well; and that the GP support in the Emergency Departments had been outstanding.

13.4     The Clinical Chair GCCG emphasised that this had been a system wide approach. Whilst a lot of the data was focused on outcomes at the acute hospitals, the achievements were down to strong partnership working across health and social care; working as one system.

13.5     In response to a question it was explained that a lot of work had gone into developing resilience at the Minor Injury and Illness Units.

13.6     Members empathised with staff concerns that they were not able to deliver the level of care that they would wish to for patients waiting on trolleys in corridors. This was acknowledged and the care and compassion of staff was recognised. The committee was informed that work was continuing to improve the process, the number of patients waiting on trolleys was tracked, and that this number had reduced. It was accepted that the system was not yet where it needed to be but there was evidence of good progress and the system had performed better than the prior year despite additional challenges such as a  ...  view the full minutes text for item 13.

14.1     The Accountable Officer, GCCG, assured the committee that the GCCG was concerned about those areas that continue to show ‘red’ in the report, and were actively working to improve these areas. Of particular concern to the committee were the cancer targets and members would continue to closely monitor these targets.

14.2     In response to a question it was explained that with regard to Early Intervention in Psychosis (EIP) the GCCG is working with the 2Gether NHS Foundation Trust to improve waiting times, and would be looking at increasing the age range in the next year.

14.3     Committee members requested a briefing on why there had been a drop in performance in quarter 3 for level 2 and 3 referral to treatment in the Children and Young People  Service (CYPS).

ACTION:        Jane Melton

15.1     With regard to the percentage of children who received a 1 year check by 1 year the Director of Public Health drew member’s attention to the improved performance. It was noted that a particular difficulty was reaching parents within the required time frame of one year.

15.2     In response to a question the committee was reminded that the recommissioned NHS Health Check programme launched on 1 April 2018.

16.1     The committee has been concerned with regard to adult social care reassessments for some time. The Director of Adult Social Services had commissioned the performance team to undertake a detailed analysis and they have worked with every team. It was identified that restrictions within the ERIC system had resulted in each locality developing their own way of recording data which has then impacted on the overall performance picture. Members were informed that work was already underway for a replacement for ERIC and this information would be included in the specification. The committee was also informed that the adult social care service has also looked at how Children’s Services have responded to the Ofsted inspection and taken learning from this process.

17.1     The STP Lead gave a detailed presentation of the report. Some members felt that the STP process was confusing and it was agreed that a workshop on the STP process would be arranged.

ACTION:        Becky Parish

17.2     The STP Lead also assured members that she was committed to keeping the committee up to date on all issues coming through this process.

The committee welcomed this report and agreed that it would take a detailed look at this report at its meeting on 8 May 2018.

19.1     The Director of Adult Social Services drew attention to the Blue Badge consultation and encouraged people to respond. It was questioned whether there were any plans to move away from using the wheelchair symbol on the badges. It was explained that the community was divided about this aspect, and it was an internationally recognised symbol. The Director indicated that if members so wished she could include this in the council consultation response, but could not see this changing.

19.2     It was commented that Highways could sometimes be a barrier to implementing/supporting disability schemes and that it would be important to ensure that they are appropriately briefed.

19.3     It was also commented that ‘invisible’ disability was a key factor, and that it was important to ensure that people understood that this was not just about wheelchair users.

The committee noted the report.

21.1     The Accountable Officer, GCCG, informed the committee that the Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) was one of the most improved Trusts in the country with to regard to Sepsis management.

21.2     In response to a question it was explained that the work to develop the Citizens Jury for the Community Hospitals in the Forest of Dean proposal was progressing and that it was expected that more information would be available at the 8 May 2018 meeting.