Agenda and minutes

Health Overview & Scrutiny Committee - Tuesday 11 January 2022 10.00 am

Venue: Council Chamber - Shire Hall, Gloucester. View directions

Contact: Jo Moore (DSU) 

Items
No. Item

32.

Apologies

To note any apologies for absence.

Minutes:

No (member) apologies were received.

 

Apologies were noted fromMary Hutton, (NHS Gloucestershire Clinical Commissioning Group, (GCCG), and from Dr Mark Pietroni, (Gloucestershire Hospitals NHS Foundation Trust (GHT). Mary was represented by Mark Walkingshaw, (Deputy Accountable Officer/Director of Commissioning) and Mark by Simon Lanceley, (Director of Transformation).

 

The Chairman welcomed Dame Gill Morgan, (Chair Designate of the Gloucestershire Integrated Care Board (ICB), to the meeting. 

33.

Declarations of Interest

To confirm any declarations of interest at the meeting.

Minutes:

No declarations of interest were made at the meeting.

34.

Minutes pdf icon PDF 126 KB

To confirm the minutes of the meeting held on 30 November 2021 (attached)

Minutes:

The minutes of the meeting held on 30 November 2021 were confirmed and agreed as a correct record of that meeting.

35.

Public Representations

At each meeting of the Health Overview and Scrutiny Committee, there shall  be up to 20 minutes set aside for members of the public, (including non- committee members), to make representations.

 

Any person who lives or works in the county, or is affected by the work of the County Council, may make a written representation on any matter which relates to any item on the Health Overview and Scrutiny Committee agenda for that meeting. Notification of the intention to submit a representation is required three clear working days before the date of the meeting, (excluding the day of the meeting). If in attendance at the meeting, the person making the representation may address the committee, (3 minutes per representative), in acknowledgement of the response to their representation.

 

The notification deadline to make representation at the committee meeting on 11 January 2022 is 4.00 pm on Thursday 6 January 2022.

Minutes:

No public representations were made at the meeting.

36.

Primary Care pdf icon PDF 3 MB

A presentation from the NHS Gloucestershire Clinical Commissioning Group (GCCG).

Minutes:

Helen Goodey, (Director of Primary Care), and Dr Andy Seymour, (Clinical Chair), from the NHS Gloucestershire Clinical Commissioning Group (GCCG), presented information on the delivery of Primary Care services in Gloucestershire before responding to questions.

 

The power-point presentation presented at the meeting can be viewed at the link here. 

 

Noting some of the challenges in delivering Primary Care services throughout the pandemic and continuing into the recovery stages, it was explained that the GP Patient Survey referred to in the presentation was an England-wide survey, providing practice level data about patients’ experiences of their GP practices. The data provided a snapshot of experiences based on data collected between January and April 2021 and published in July 2021.

 

Some of the positive information identified by the data, included: - 

 

a)    Ease of getting through to GP practice on the telephone - 81% of patients in Gloucestershire had found the process easy, compared to 68% nationally;

 

b)    Helpfulness of receptionists - 92% of patients in Gloucestershire had found receptionists helpful, compared to 89% nationally;

 

c)    Ease of use of online services - 80% of patients in Gloucestershire reported access to GP Practice’s websites, (to seek information), and access to services had been easy, compared to 75% nationally.

 

d)    Comparisons in providing face to face appointments during the pandemic, (as compared to those in 2019), had confirmed 11% more appointments provided during the pandemic than had been provided during the pre-covid period. There had been 22,654 more GP appointments provided in November 2021 than in November 2019. Patients continued to be seen face-to-face, if clinically appropriate.

 

Members were informed that, whilst performing higher than most national averages, access to some GP services in Gloucestershire continued to be a challenge and was often variable, depending on GP location. Current challenges included; GPs suffering from fatigue/at risk of burnout; sickness levels and vacancies anticipated to rise; low morale across all GP practice staff, with some receptionists and practice managers leaving their place of employment.

 

GP levels in Gloucestershire were currently at a higher level than the national average and in the South West. However, some local trends had recently experienced deteriorations, (not reflected by national and regional averages). It was confirmed that, historically, Gloucestershire had been resilient to overcoming obstacles in delivering Primary Care services and had continued to provide a robust service/deliver good outcomes. This had been significantly impacted on in recent years, particularly during the current climate where the impact of Covid-19 related challenges had been unprecedented and not easy to manage.

 

In terms of online demand, Gloucestershire had been identified as having one of the highest demands in England during the pandemic. Demand had recently stabilised to around 55-60k patient requests per month during the past 6 months.

 

Throughout 2021, whilst continuing to manage the ongoing needs of patients, it had been necessary for Primary Care services in Gloucestershire to create/ operate COVID 19 Vaccination Centres. During this time, care had been taken to prioritise/deliver services for those most  ...  view the full minutes text for item 36.

37.

One Gloucestershire Integrated Care System Update pdf icon PDF 721 KB

An update on the progress being made in working towards the further integration of health and care services, (subject to the progression of the Health and Care Bill 2021-22), and the introduction of a formal Integrated Care System arrangement for Gloucestershire in July 2022.

Minutes:

The committee received an update on the progress in working towards the further integration of health and care services, (subject to the progression of the Health and Care Bill 2021-22), and the anticipated introduction of a formal Integrated Care System arrangement for Gloucestershire in July 2022.

 

 

 

38.

Temporary Service Change - Hyper Acute Stroke Services Unit pdf icon PDF 603 KB

The committee is invited to note the attached report and comment on an emergency temporary service change relating to the delivery of Hyper Acute Stroke services in Gloucestershire.

Minutes:

The committee noted information on the temporary relocation of Gloucestershire Hospitals NHS Foundation Trust’s Hyper Acute Stroke Unit from Gloucestershire Royal Hospital (GRH) to Cheltenham General Hospital (CGH). It was explained that the change would be implemented as a temporary service change under the Memorandum of Understanding (MOU) arrangement in place between the Gloucestershire Integrated Care System (ICS) and the Gloucestershire Health Overview and Scrutiny Committee (HOSC).

 

Details of the temporary service can be viewed in the report presented at the meeting here. Please refer to Annex 2 of the report for details of the MOU.

 

It was explained that the temporary change was part of the ICS response to addressing increasing winter pressures, (emergency attendances and admissions), Stroke Consultant and Specialist Nurse workforce challenges and the anticipated increase in hospital attendances and admissions relating to the Omicron variant of COVID-19. Collectively, the combination of such pressures could significantly impact on the ability to consistently deliver a high-quality stroke service in Gloucestershire.

 

The service change to be implemented as an emergency, (temporary), service change in line with the agreed MOU, and in addition to the existing emergency, (temporary), change that resulted in the transfer of the Acute Stroke Unit (ASU) to CGH during the first wave of COVID-19. The proposed move to centralise all acute stroke beds onto the one site at CGH. A stroke consultation service to be provided at the GRH site to manage inpatient referrals.

 

A further update on emergency temporary service changes introduced in response to the COVID-19 Pandemic during 2020/21 to be presented to the committee on 8 March 2022.

 

Pending further updates, the committee noted the proposed temporary, (emergency), service change to transfer the Hyper Acute Stroke Unit at Gloucestershire Royal Hospital to Cheltenham General Hospital.  

39.

NHS Gloucestershire Clinical Commissioning Group (GCCG) Performance Report pdf icon PDF 2 MB

To receive an update on the performance of the Gloucestershire Clinical Commissioning Group (GCCG) against NHS constitutional and other agreed standards.

Minutes:

The committee received an update on the performance of the local NHS based on a range of national priorities and other agreed local standards.

 

The report included an update on ambulance response times in Gloucestershire by the South West Ambulance Service Foundation Trust (SWAST). 

 

To view the performance report please open the link here

 

Key information referred to in the performance report included: -

 

1)    CCG NHS Oversight assessments for 2019/20 published on 25 November 2021 had rated Gloucestershire CCG as ‘good’ overall;

 

2)    Performance against key standards was continuing to follow national trends. Overall, general performance in Gloucestershire was improving and better than the national position, with the exception of the performance indicator for the category 1 ambulance response target, (responding to category 1 calls in 7 minutes), which continued to decline nationally in response to increased pressures on ambulance trusts throughout the UK;

 

3)    Gloucestershire’s cancer services continued to perform well. However, the 62 day performance had dropped consistently in recent months and had been further impacted on by recent pathology backlogs and IT/lab issues;

 

4)    Data recorded in September 2021 for Gloucestershire out of hours services activity reduced by 6.7% from the previous month and was slightly below average;

 

5)    The 18 week ‘Referral to Treatment’ (RTT) focuses on the entire patient journey from the initial referral to the start of treatment, including the first time treatment was undertaken in an outpatient setting. For example, the time taken from when a GP referred a patient to hospital to when the patient finally received treatment or had an operation. The performance is usually shown as a percentage of people who receive treatment within 18 weeks. The target is set at 92% for patients to receive treatment with the 18 weeks.

 

6)    The ‘Cancer 2 Week Wait’ target refers to a two week wait referral target following a request made by the patient’s General Practitioner (GP) to arrange an urgent hospital appointment because the patient may have symptoms to indicate they may have cancer. The performance target is usually shown as a percentage of people who have been seen by a cancer specialist within 2 weeks. The target states that, following an urgent GP referral for suspected cancer, at least 93% of patients should be seen by a specialist within two weeks.

 

7)    The ‘Cancer 62 Day Target’ refers to all urgent and non-urgent cancer referrals in a target time of 62 days or less, i.e. when cancer is first suspected. The ambition is for everyone to have a confirmed diagnosis and start treatment within 62 days. The initial referral is usually made by the patient’s GP via the 2 week wait cancer target. Referrals can also be made by screening services. The cancer treatment start date should be within 62 days of when the GP referral was received by the hospital and within 31 days of when the decision to commence treatment has been agreed, (when the patient and clinician have agreed on the treatment option and the  ...  view the full minutes text for item 39.

40.

One Gloucestershire Integrated Care System Report (ICS) pdf icon PDF 849 KB

An update from the One Gloucestershire Integrated Care System (ICS) Partnership.

 

NHS Partners include: -

 

NHS Gloucestershire Clinical Commissioning Group (GCCG)

Primary Care (GP) Providers

Gloucestershire Health and Care NHS Foundation Trust (GHC)

Gloucestershire Hospitals NHS Foundation Trust (GHT)

South West Ambulance Service NHS Foundation Trust (SWASFT)

Minutes:

The committee received an update on the work of the One Gloucestershire Integrated Care System (ICS). NHS Partners include: NHS Gloucestershire Clinical Commissioning Group; Primary Care (GP) Providers; Gloucestershire Health and Care NHS Foundation Trust; Gloucestershire Hospitals NHS Foundation Trust and South West Ambulance Service NHS Foundation Trust. 

 

To view the report published with the agenda for the meeting please visit the link here

 

Members noted the progress being made in working towards the further integration of health services, (subject to the progression of the Health and Care Bill 2021-22), which would enable the Gloucestershire Integrated Care System to commit to a formal partnership arrangement in 2022.

 

It was confirmed that a new target date for the legal and operational establishment of the new arrangement had been announced by NHS England on 24 December 2021. Commending the progress that had been made in preparing for the establishment of Statutory Integrated Care Systems, NHS England had announced that, in order to allow sufficient time for the remaining parliamentary stages of the process, a new target date of 1 July 2022 had been agreed for the statutory arrangements to take effect and for ICBs to be legally and operationally established.

 

Responding to concerns about the impact of the pandemic on mental health, members were reassured that this aspect of work was an area of key focus for the One Gloucestershire Integrated Care Partnership and that a number of initiatives had been developed to meet the impact of increased demands on services. Updates on the initiatives, including those to address the increased number of eating disorders across the county would be reported as part of the performance report at future meetings.

 

It was noted that a new wellbeing service was about to be launched to provide mental health and wellbeing support for people working in health and social care in Gloucestershire. The ‘Wellbeing Line’ was a confidential, free of charge service.

 

Noting the work of the Patient Advisory Liaison Service (PALS), it was agreed to provide details of how to access the service after the meeting. PALS is a confidential service, providing information, advice and support for patients, families and carers. PALS seek to promote the importance of listening to patient enquiries and concerns. To support this aim, the PALS Teams work closely with staff who have direct contact with patients, their families and carers, providing help and information regarding enquiries or concerns raised by those receiving care or treatment.

 

PALS services in Gloucestershire include: -

 

Primary care and commissioning: https://www.gloucestershireccg.nhs.uk/about-you/your-experience/complaints-compliments-concerns/

For general enquiries, call NHS Gloucestershire CCG PALS on Freephone 0800 0151 548 or land-line 01452 566698. The phone lines have an answering service for messages to be left at any time. Alternatively, email glccg.pals@nhs.net

 

Acute Hospitals and maternity services (CGH, GRH and Stroud Maternity Hospital) https://www.gloshospitals.nhs.uk/contact-us/patient-advice-and-support/ Telephone 0800 019 32

 

Community, mental health and learning disability services https://www.ghc.nhs.uk/get-in-touch/give-us-views/

 

The ICS report was noted.

41.

Work Plan pdf icon PDF 53 KB

To note the dates of future meetings and agree items to include on the committee work plan.

 

11 January 2022

08 March 2022 (a joint meeting with the Adult Social Care and Communities Scrutiny Committee)

17 May 2022

12 July 2022

13 September 2022 (the date of this meeting may change to allow the committee to consider the NHS Winter Plan 2022-23)

15 November 2022

Minutes:

Noting the items for consideration at the joint committee meeting on 8 March 2022, including the review of the Gloucestershire Urgent and Emergency Care Winter Sustainability Plan 2021/22 and an update on the development of the Integrated Care System, (to form part of the regular ICS report to the committee), members were asked to suggest other items as items for consideration at future meetings.

 

Items suggested at the meeting included:

 

1.    JUYI System (computer system used by doctors, nurses and others to access digital shared care records). The JUYI System will enable patient data to be shared between a wide range of services within the Health & Care System across the County.

 

2.    Children’s Weight Management

 

3.    Health Inequalities

 

4.    System Flow

 

Chair, Cllr Andrew Gravells, welcomed the suggestions and encouraged members to submit any further suggestions via email to jo.moore@gloucestershire.gov.uk after the meeting.