Agenda and minutes

Health Overview & Scrutiny Committee - Thursday 22 October 2020 10.00 am

Venue: Virtual Meeting - Web ex meeting. View directions

Contact: Jo Moore Email: (jo.moore@gloucestershire.gov.uk) 

Items
No. Item

1.

Apologies for Absence

To note any apologies for absence.

Minutes:

Apologies were received from Cllr Helen Molyneux, (Forest of Dean representative), and Cllr Paul Hodgkinson, (Gloucestershire County Council representative). Cllr Bernie Fisher substituted for Cllr Hodkinson at the meeting.

 

Apologies were also received from Cabinet Members, Cllr Tim Harman and Cllr Kathy Williams.

2.

Declarations of Interest

To advise of any pecuniary or personal declarations of interest on matters relating to the agenda.

Minutes:

No declarations of interest were made at the meeting.

3.

Minutes pdf icon PDF 174 KB

To confirm the minutes of the meeting held on 15 September 2020

Minutes:

The minutes of the meeting held on 15 September 2020 were agreed as an accurate record of that meeting.

4.

Public Representation

The Gloucestershire Health Overview and Scrutiny Committee is currently piloting an approach whereby members of the public can make representations at committee

meetings.

 

At each meeting of the Health Scrutiny Committee, there shall be up to 20 minutes set aside for representations, (3 minutes allocated per member of the public).

 

Any person who lives or works in the county, or is affected by the work of the County Council, may make a representation on any matter which relates to any item on the Health Overview and Scrutiny Committee agenda for that meeting.

 

Notification of your intention to attend the meeting and make a representation should be given by 4.00 pm three clear working days before the date of the meeting, (excluding the day of the meeting).

 

The notification deadline to make representation at the committee meeting on Thursday 22 October 2020 is 4.00 pm on Friday 16 October 2020.

 

To confirm your request to make a representation, please email Jo Moore on jo.moore@gloucestershire.gov.uk

 

Please note, this meeting will be held as a remote access meeting, for which it will be necessary to join the meeting by electronic means via the Webex application. An invitation to join the meeting will be provided prior to the meeting. If you have any questions on this process, please include in the email.

Minutes:

Agenda item 6 - Forest of Dean Community Hospital Consultation

 

The following representation was made by Mr John Thurston on behalf of Friends of Lydney Hospital. 

 

Statement

 

Our question does not apply to the provision of inpatient beds but to the loss of other local services in the South Forest if Lydney Hospital is completely closed.

 

In recent years Outpatients and Urgent care visits to Lydney are many times the number of inpatients visits and are the mostly highly valued aspects of the local provision.

 

In the very short time available, we have not been able to digest all of the papers, but we are pleased to see that there is an acknowledgement of the representations that have been on loss of services. We would welcome an opportunity to partake in a constructive working group, however presently, there is no commitment that funding will be made available to provide those services or that they are considered necessary.

 

Knowing the current resource, buildings and people, we see no evidence that there is an ability to provide and fund such a provision despite the plans to close the existing hospital. 

 

We were encouraged to support the case for a single hospital with inpatient beds for the three towns on the understanding that comprehensive health provision would be made in the other two towns.

 

Lydney and South Forest is the largest and fastest growing area of the Forest of Dean. Transport and travel are not good, and many people live outside or on the 30 minutes travel time.  The passenger miles will substantially increase without a local health hub.

 

Our aspiration is to replace the lost services (and others) in a new innovative 21st Century facility. We are now an ever increasingly, 365/7/24 hour society, expecting immediate response and those in rural areas have an equal right to partake. Over many years we have had good provision and do not wish to be disadvantaged.

 

The Friends of Lydney and District hospital are prepared to offer support to new services in Lydney.

 

Response from Ellen Rule: Director of Transformation and Service Redesign for the Gloucestershire NHS Clinical Commissioning Group (CCG) on behalf of the One Gloucestershire Integrated Care System (ICS).

 

Acknowledging the concerns, the Director of Transformation and Service Redesign clarified that the focus of the consultation would be on the services to be contained within the new single hospital to be built in the Forest of Dean.  As outlined in the meeting documentation, there had been significant previous engagement and consultation resulting in the decisions to consolidate the existing two hospitals into a single site, the location for that facility being Cinderford.

 

It was recognised that some of the feedback that had been received had suggested that residents from the South of the Forest would receive a lower level of provision to that which they currently received due to access and travel difficulties. Therefore, alongside the consultation, it was proposed that CCG convene a working group to consider how it  ...  view the full minutes text for item 4.

5.

Fit for the Future Update pdf icon PDF 678 KB

To consider the proposals and outline plan for consultation relating to the next phase of the  Fit for the Future Programme.

 

  • Acute Medicine (acute medical take)
  • Gastroenterology inpatient services - medical care for stomach, pancreas, bowel or liver problems
  • General Surgery - conditions relating to the gut. Specifically, emergency general surgery, planned lower gastrointestinal (colorectal) surgery and planned day case surgery 
  • Image Guided Interventional Surgery (IGIS) – where surgeons use instruments with live images to guide the surgery
  • Trauma and Orthopaedic inpatient services (T&O) - diagnosis and treatment of conditions relating to the bones and joints

Additional documents:

Minutes:

Ellen Rule, Director of Transformation and Service Redesign for the Gloucestershire NHS Clinical Commissioning Group, (representing One Gloucestershire Integrated Care System), set out the proposals and outline plan for the ICS Consultation on the development of specialist hospital services at Cheltenham General (CGH) and Gloucestershire Royal (GRH) Hospitals. The consultation will form part of the Gloucestershire Fit for the Future Programme and the long term vision of ensuring Gloucestershire is placed at the forefront of healthcare delivery nationally.

 

To date, the programme has focussed on two areas of work;

 

1)    Developing a joined up responsive approach to offering community based urgent care; and

 

2)    Developing the ‘Centre of Excellence’ model of care for delivering specialist care services.

 

The set of proposals for consideration at this meeting related to the development of Centres of Excellence for specialist hospital based care within hospitals operated by the Gloucestershire Hospitals NHS Foundation Trust. The focus of developing this model of care was to ensure patients with serious illnesses or injuries received specialist treatment with the appropriate specialist staff, skills and equipment from which to achieve the best possible outcomes and experiences.

 

5.1 Noting strong expressions of concern from some members of the committee about the timing of the consultation in relation to the challenges and pressures presented by the COVID-19 pandemic, the Director of Transformation and Service Redesign advised members that, to delay the consultation was not an option and could seriously hinder the process. The committee noted the significant benefits anticipated from the changes and the importance of consulting at this time. The consultation follows an extensive period of public and staff engagement.

 

5.2 Members were advised that the Gloucestershire Memorandum of Understanding (MOU), (produced to assist the committee when making a recommendation to the CCG to consult), would not be required in relation to the two consultations for consideration at this meeting. The consultations formed part of a long running programme, each with a clear consultation timetable in place.

 

5.3 For clarification, it was explained that the purpose of the presentation at this meeting was to seek the committees views on the decision to go out to public consultation on proposals relating to the reorganisation of specialist services at Cheltenham General (CGH) and Gloucestershire Royal (GRH) Hospitals. The services included:-

 

Ø  Acute Medicine (specifically acute medical take)

Ø  Gastroenterology inpatient services - medical care services for stomach, pancreas, bowel and liver problems

Ø  General Surgery - conditions relating to the gut. Specifically, emergency general surgery, planned lower gastrointestinal (colorectal) surgery and planned day case surgery 

Ø  Image Guided Interventional Surgery (IGIS) – including vascular surgery. This area of work involves the use of instruments with live images to guide the surgery

Ø  Trauma and Orthopaedic inpatient services (T&O) - diagnosis and treatment of conditions relating to the bones and joints

 

5.4 The committee noted the steps that had been taken to proceed to the consultation, including the mitigations considered  ...  view the full minutes text for item 5.

6.

Forest of Dean Community Hospital pdf icon PDF 788 KB

To consider the proposals and outline plan for consultation relating to the development of the new community hospital for the Forest of Dean.

Additional documents:

Minutes:

The committee considered proposals from the Gloucestershire Integrated Health and Care System (ICS) to commence the final formal stage of public consultation on the range of services to be provided at the new community hospital for the Forest of Dean. Based on the outcomes of previous phases of engagement and consultation, the planned hospital will be built in Cinderford and will replace the Dilke Memorial and Lydney and District Community Hospitals. The two existing hospitals will close when the new hospital has opened.

 

6.1 The new proposals have been developed following extensive engagement with local communities and clinicians from the Forest of Dean consulted on over several years. 

 

6.2 During the last period of engagement, several issues were raised. These will be considered in the next phase of consultation and include: - 

 

a)    Proposed inpatient capacity in the new hospital

b)    Urgent Care provision for the district, and in particular for residents of the South of the Forest (based on the confirmation that the new hospital will be located in Cinderford)

c)    End of Life Care provision

d)    Travel and Access

 

6.3 The committee noted the proposals, including the responses to the specific areas of interest raised during previous consultations. In addition, the committee noted information on the other services to be provided at the new hospital plus an overview of historic activities and proposed timelines for the next stages of the programme.

 

6.4 It was confirmed that all key assurances for the new proposals had been met and any challenges presented by the COVID-19 pandemic would be taken into account and managed during the consultation process.

 

6.5 A summary of bed test requirements for the proposed 24 beds for the hospital was outlined in the covering report to the committee. 

 

6.6 One of the proposals related to the creation of an urgent care centre at the new facility. The new care centre would replace existing facilities at the Lydney and Dilke hospitals and operate from 8am to 8pm 7 days a week.

 

6.7 In response to concerns about the provision of urgent care for residents living in the South of the Forest and anticipated difficulties to access the new hospital, it was confirmed that a working group would convene to explore the options for providing urgent care in Lydney. Comments made by Mr John Thurston on behalf of the Friends of Lydney Hospital considered earlier in the meeting were noted.

 

6.8 It was acknowledged that travel and access remained a concern, particularly in terms of access to services from the far North and South of the District. It was further acknowledged that public transport provision in the Forest was, overall, generally poor. Discussions with the Forest of Dean District Council to seek to improve bus routes to the new hospital were ongoing.

 

6.9 Continuing with the issue of access arrangements to the new hospital, it was confirmed that travel and access had been a consistent theme in all stages of the engagement process, with detailed analysis of car ownership  ...  view the full minutes text for item 6.

7.

Work Plan

To note the dates of future meetings and suggest items for consideration.

 

17 November 2020

12 January 2021

2 March 2021

15 June 2021

13 July 2021

14 September 2021

16 November 2021

 

Minutes:

The following items were added to the committee work plan for consideration at the November and January committee meetings.

 

17 November 2020

 

Ø  Community Phlebotomy Services Update

Ø  SWASFT Performance Indicators (to include an update on ambulance response times in response to COVID-19 requirements) – it was noted that this item was dependent on the SWASFT being able to attend the meeting at short notice

Ø  Consultation Progress Updates - to be included in the Accountable Officer Reports

Ø  COVID19 Update – to be included in the Accountable Officer Reports

Ø  Review of HOSC Public Representation Process

Ø  Standard Accountable Officer Update Reports

 

In response to recent reports of ambulances queuing when admitting patients to Gloucestershire Royal Hospital, the committee agreed it would be useful if the planned item to consider ambulance service performance indicators included information on the impact of the pandemic and on ambulance arrival times at GRH

 

Tuesday 12 January 2021

 

Ø  Consultation Response Review – Fit for the Future

Ø  Consultation Response Review – FOD Community Hospital

Ø  Standard Accountable Officer Update Reviews

 

Noting concerns at this and the previous meeting about HOSC members, (in particular co-opted district members), no longer having an opportunity to engage or ask questions on social care/mental health issues considered under the remit of the County Council’s Adult Social Care and Communities Scrutiny Committee meetings, it was suggested that a discussion on the revised role of the committee and an update on the scrutiny review of the changes to the GCC scrutiny function made by full council in 2019 be included on the agenda at the January committee meeting.

 

Members reinforced the strength of the discussion with concerns about not being able to direct questions to the GCC Director of Public Health and the Executive Director of Adult Social Care at HOSC meetings on the county’s response to the COVID-19 emergency. (Note: The Director of Public Health has since agreed to attend the November HOSC meeting to respond to the committee’s questions).

 

Noting the decision made by Gloucestershire County Council to split the remit of the Gloucestershire Health and Adult Social Care Scrutiny Committee to provide proper scrutiny of both areas, it is further noted that, included within this decision is the proposal that two joint meetings be held each year to specifically consider issues around the remit of the former committee. Within the council decision, it was recognised that close links between Health, Adult Social Care and Children’s Services and the national agenda around health and care would mean holding joint briefings and task groups required from time to time involving health professionals.

 

Note: A joint meeting involving HOSC members and the GCC Adult Social Care and Communities Scrutiny Committee will be held on 26 January 2021.

 

Committee Chair, Cllr Brian Robinson, noted the committees concerns and informed members that he would accept questions on issues relating to the COVID-19 emergency at future HOSC meetings.

 

It was confirmed that a review of the county’s scrutiny arrangements agreed by GCC  ...  view the full minutes text for item 7.