Agenda and minutes

To note any apologies for absence.

Apologies were received from Cllrs Pam Tracey, Stephan Fifield and Jill Smith.

To report any declarations of interest.

No declarations of interest were made at the meeting.

To confirm the minutes of the Gloucestershire Health Overview and Scrutiny Committee meeting held on 12 July 2022.

The minutes of the meeting held on 12 July 2022 were confirmed and agreed as an accurate record of that meeting.

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 representation at the meeting. The process for making a representation will follow Gloucestershire County Council Constitution rules for representations at public meetings.

The Council’s Constitution states that ‘any person who lives or works in the county, or is affected by the work of the County Council, may make written representation on any matter which relates to an item on the Health Overview and Scrutiny Committee agenda for that meeting’.

Notification of the intention to make representation at this meeting is required three clear working days before the date of the meeting, (excluding the day of the meeting). Where the person making representation attends the meeting in person, that person will be invited to address the committee, (3 minutes per representative), to respond to the information provided in reply to the original representation.

The notification deadline to make representation at the committee meeting on 18 October 2022 is 4.00 pm on Wednesday 12 October 2022. Please submit any questions in writing via email to jo.moore@gloucestershire.gov.uk                   

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No public representations were made at the meeting.

To consider proposals relating to the NHS Gloucestershire Winter Sustainability Plan 2022/23.

Eve Olivant and Mary Hutton from NHS Gloucestershire outlined proposals relating to the NHS Gloucestershire Winter Sustainability Plan 2022/23.

Please refer to the presentation document published with the agenda for details of the proposals. 

Responding to questions, NHS Gloucestershire, acknowledged the challenges presented by the potential spread of new variants from the Covid-19 Coronavirus, in addition to anticipated pressures likely to impact on NHS services from large numbers of people experiencing flu symptoms.

In response to the challenges, it was clarified that the proposals set out in the Winter Sustainability Plan 2022-23 did not differ significantly from the activities included in the Winter Plan from the previous year.

The focus of the new plan would concentrate on the following areas of activity:

Ø  Prepare for new COVID-19 variants and other respiratory challenges

Ø  Increase the amount of care provided outside hospitals, notably, in  Primary Care and Mental Health

Ø  Increase the resilience provided by NHS 111 and 999 services

Ø  Improve 999 Cat 2 responses and reduce ambulance handover times

Ø  Expand the availability of alternative services without patients having to go to an acute hospital

Ø  Reduce demands placed on acute and community hospital wards

Ø  Ensure people are discharged safely and quickly from acute, mental health, and community settings

Ø  Provide better support for people at home, including expanding ‘virtual wards’

Responding to questions on the response to new variants of the coronavirus and the measures in place to deliver the Covid-19 booster and flu vaccination, it was reported that: -

1. Covid-19: The Joint Committee on Vaccination and Immunisation (JCVI) had set out the following recommendations for the Autumn Coronavirus (COVID-19) Booster Programme. Those eligible for a further vaccine dose included:

Ø  All adults aged 50 years and over

Ø  Those aged 5 to 49 years in a clinical risk group, including pregnant women

Ø  Those aged 5 to 49 years who are household contacts of people with immunosuppression

Ø  Those aged 16 to 49 years who are carers

Ø  Residents in a care home for older adults and staff working in care homes for older adults

Ø  Frontline health and social care workers

2. Flu Vaccine.

Although it was initially thought those eligible for the flu vaccine would be those over 65 and those in clinical risk groups, the Department of Health and Social Care (DHSC) had since announced it would be widening the offer of the free flu vaccine to more eligible groups. The additional groups would only be eligible after the most vulnerable, including previously announced pre-school and primary school children, those aged 65 years and over and those in clinical risk groups, have been offered the vaccine.

For further information, please visit https://www.gov.uk/government/news/over-50s-to-be-offered-covid-19-booster-and-flu-jab-this-autumn

NHS Gloucestershire confirmed it would be encouraging as many people as possible to have their vaccinations. This included those eligible to visit local pharmacies and drop in centres where vaccines were being offered. Recent reports confirmed, Gloucestershire, as a county was once again performing exceptionally well, (the highest in the  ...  view the full minutes text for item 5.

Members to consider a report in response to Council Motion 881, (Tackling Poverty and Deprivation in Gloucestershire). At the Council meeting on 8 September 2021, it was agreed to ‘bring regular progress reports on the progress of the Health and Wellbeing Board’s seven strategic priorities to the Health Overview and Scrutiny Committee’.

The report to include an update on the outcomes of the Gloucestershire Levelling Up Our Communities Conference held on 19 May 2022.

At the Gloucestershire County Council meeting on 8 September 2021, members considered Motion 881, (Tackling poverty and deprivation in Gloucestershire), with a request to ‘bring regular progress reports on the progress of the Health and Wellbeing Board’s seven strategic priorities to the Health Overview and Scrutiny Committee’. To view the discussion at the council meeting on 8 September 2021, please visit the Council website at the link here

Acknowledging common interests with the Adult Social Care and Communities Scrutiny Committee, members received a presentation from Kate Emsley, Senior Commissioning Manager at Gloucestershire County Council, on the impact of inequalities on the health and wellbeing on different groups of people in Gloucestershire. Please refer to the attached PowerPoint for details of the presentation.

Incorporated within the report was an overview of the outcomes of the Gloucestershire Levelling Up Our Communities Conference held on 19 May 2022. Recent data indicated that Gloucestershire enjoyed overall good health and life expectancy, thus emphasising a need to work hard to uncover and understand any inequalities that existed.

The work to concentrate on the seven strategic priorities identified by the Gloucestershire Health and Wellbeing Board (HWBB). These included: Physical Activity, Adverse Childhood Experiences (ACEs), Mental Wellbeing, Loneliness and Social Isolation, Healthy Weight, Best Start in Life and Housing. It was explained that the priorities had been considered as HWBB priorities since 2019, with regular updates and reports at HWBB meetings. Each priority received dedicated agenda time to ‘spotlight’ the area in terms of progress, opportunities and challenges.

‘Highlight’ reports, reporting on each of the seven strategic priorities had been considered at a HWBB meeting held in September, in addition to a performance update report, comprising indicators for each priority area.

Key highlights identified from the reports included: -

1. Physical activity - distribution of over £250,000 grant funding; a pilot approach used to social prescribing for young people; delivery of on-line workshops for communities, clubs and organisations; strength and asset-based delivery in geographical areas of inequality;

2. Adverse Childhood Experiences (ACEs) - evidence of good professional knowledge of ACEs; 138 ACE Ambassadors forming a network of people to champion ACEs awareness across Gloucestershire; Action on ACEs’ partnered with the Nelson Trust to roll out training to 160 people from VCS organisations and ACEs Ambassadors

3. Mental wellbeing – roll out of a £200k community grants scheme for community led and based projects aimed at addressing the wider determinants of mental health and Five Ways to Wellbeing initiative, focusing on groups at highest risk of poor mental health and social isolation; provision of new early intervention mental health services throughout the pandemic to improve access to support for children and adults experiencing mild-moderate mental health issues working alongside existing commissioned services; completion of a suicide audit to inform a refresh of the countywide suicide prevention strategy and action plan; ongoing delivery of training in suicide prevention, mental health and crisis care awareness for VCS and public sector organisations.

4. Loneliness and social isolation – it was noted  ...  view the full minutes text for item 6.

This item was considered as an item of urgent business in accordance with Paragraph 7 of Part 4 of the Council’s Constitution: Rules of Procedure/Rules on Access to Information about the County Council’s Formal Business.

The item was added to the agenda at the request of the Chair of the Gloucestershire Health Overview and Scrutiny Committee, Cllr Andrew Gravells. 

Under consideration of the urgent item, members of the Gloucestershire Health Overview and Scrutiny Committee were invited to ask questions on the Care Quality Commission (CQC) Gloucestershire Hospitals NHS Foundation Trust Inspection Report published by the CQC on 7 October 2022. The report relates to inspections of Gloucestershire Royal Hospital and Cheltenham General Hospital on 12-13 April 2022 and 14-16 June 2022.

Representatives from the Gloucestershire Hospitals NHS Foundation Trust in attendance at the meeting gave a verbal update on the findings of the inspection report and responded to questions from the members of the committee. Please see attached the summary report presented at the meeting.

To visit the CQC webpage please go to the link here

To view the inspection report relating to the inspection of Gloucestershire Hospitals (published on 7 October 2022) please go to the link here

Please also refer to section 3.1.2 of the One Gloucestershire NHS Integrated Care Board Report at item 8 of the agenda for comments from the GHNHSFT.

To view the extensive committee discussion on the item, please visit the Gloucestershire County Council website at the link here for a recording of the meeting.

Pending the response to the Care Quality Commission (CQC) Inspection report, members agreed to await until the formal response was publically available, and in the meantime, requested to have sight of the Gloucestershire Hospitals NHS Foundation Trust Action Plan to consider the 49 actions that had been agreed.

To receive an update on the performance of the Gloucestershire Integrated Care System (GICS) against NHS constitutional and other agreed standards.

The committee received an update on the performance of the Gloucestershire Clinical Commissioning Group (GCCG) in relation to NHS constitutional and other agreed standards. The report was taken as read at the meeting and can be viewed at the link here.

Responding to specific issues involving potentially personalised information, members were advised to contact NHS Gloucestershire representatives after the meeting to discuss the issues in more detail.

The update was noted.

A report from the One Gloucestershire NHS Integrated Care Board (ICB), known collectively as NHS Gloucestershire.

The report to include updates from NHS representatives and partners responsible for overseeing the day-to-day running of the NHS in Gloucestershire, including the commissioning, (buying), of services and the development of plans to meet the health needs of the local population.

The committee received a detailed update on the One Gloucestershire Integrated Care System (ICS) Partnership, (the ICP received formal recognition on 1 July 2022). The report was produced by the One Gloucestershire NHS Integrated Care Board.

One member enquired about the Lydney/South Forest GP provision going forward and agreed to receive an update after the meeting.

The report was taken as read at the meeting and can be viewed at the link here.

Members to note the attached Output of Engagement Report relating to the NHS Gloucestershire Fit For The Future 2 Programme (work to develop specialist health services in Gloucestershire) and to consider proposed next steps.

A briefing paper and Fit for the Future 2 Output of Engagement Report was shared with committee members in advance of the meeting, with a request for questions or points of clarification to be sent to the NHS in advance of the meeting.

No questions or points of clarification were received ahead of the meeting.

The report was taken as read at the meeting.

To view the full report, please visit the Fit for the Future 2 Project page on the Get Involved in Gloucestershire online participation platform:  https://getinvolved.glos.nhs.uk/fit-for-the-future-2

NHS colleagues confirmed that the Output of Engagement Report, (setting out all the engagement activity and responses to the engagement that took place during May and June 2022), had been reviewed by Gloucestershire Hospitals NHS Foundation Trust, the ICB and NHS England. The quality of the report was noted by the committee.

In response to member questions, NHS colleagues confirmed that, as part of the overall engagement with people and communities, key stakeholders, voluntary and community sector partners, GP Practice Patient Participation Groups (PPG) were invited to participate in the engagement over the summer.

The committee discussed next steps and considered whether further public involvement would provide additional information, such as alternatives or impacts, that could influence decision making. The committee concluded that the engagement undertaken to date was sufficient and requested that updates be brought to future meetings of the committee regarding the implementation of Fit for the Future 2 service changes.

To note the dates and items for consideration at future meetings.