Agenda and minutes

To note any apologies for absence.

The following apologies were noted at the meeting: -

Cllr Stephan Fifield, (it was explained that, following his recent cabinet appointment, Cllr Fifield was no longer able to sit on the committee). The new committee membership would be confirmed at the Gloucestershire County Council meeting the following day, 24 May 2023.

Cllr Linda Cohen – no substitution

Following the recent local council elections and district appointments at local authority annual meetings, the following membership updates were noted.

Cheltenham Borough Council: Cllr Adrian Bamford (no change)

Cotswold District Council: no representation at this meeting (confirmation to be made in July)

Forest of Dean District Council: no representation at this meeting (Cllr Julia Gooch has since been confirmed as the Forest of Dean District Council representative for the 2023/24 committee year)

Gloucester City Council: Cllr Collette Finnegan (no change)

Stroud District Council: Cllr Helen Fenton (no change)

Tewkesbury Borough Council: no representation at this meeting (confkrmation to be made in July)

Due to an NHS National Conference in London, the following officers were unable to attend the meeting and gave their apologies.

Sarah Scott – represented by Siobhan Farmer (County Council)

Mary Hutton – represented by Ellen Rule (NHS Gloucestershire)

Ingrid Barker – represented by Graham Russell (Gloucestershire Health and Care Foundation Trust)

Angela Potter – represented by Des Gorman (Gloucestershire Health and Care Foundation Trust)

Douglas Blair – replacing Paul Roberts as the new CEO of Gloucestershire Health and Care Foundation Trust

Other apologies: Nikki Richardson – Healthwatch Gloucestershire

To report any declarations of interest.

Cllr Collette Finnegan declared a personal interest following the recent appointment as a working volunteer for the Gloucestershire Health and Care Foundation Trust.

To confirm the minutes of the meeting held on 14 March 2023

The minutes of the meeting held on 14 March 2023 were confirmed and agreed as a correct record of that meeting.

The committee noted the information that had been provided by NHS Gloucestershire in response to public representations made at the meeting on 14 March 2023, (relating to the Practice Plus Group delivery of the GP Out of Hours Service).

The following statement, (made on behalf of the Health Overview and Scrutiny Committee), formed part of the response.

Statement issued on behalf of the Committee

In fulfilling its scrutiny function, the Gloucestershire Health Overview and Scrutiny Committee, (HOSC), has taken a particular interest in the performance of the NHS 111 and GP Out of Hours Service in Gloucestershire.

During the past six months, the committee has received regular updates on the performance of the service. As part of its work, and to gain a better understanding of some of the issues impacting on the service, lead members, including Chair of the Committee, Cllr Andrew Gravells, and Vice-Chair, Cllr David Drew, visited the Practice Plus Group, (PPG), Call Centre at Stoke Gifford, Bristol, in November 2022.

Following the visit, and in response to the Care Quality Commission Inspection of the Gloucestershire GP Out of Hours Service in November 2022, the Chair and the Vice-Chair requested that an update be provided to the committee at its meeting on 14 March 2023, inviting representatives from the CQC and from the Practice Plus Group to give detailed presentations, and to respond to questions. Representations from members of the public were also considered at the meeting, outlining individual concerns about the performance of the Gloucestershire GP Out of Hours Service.

In response to the representations, and noting the committees’ ongoing concerns about the performance of the GP Out of Hours Service, NHS Gloucestershire produced a briefing note on the outcomes of the CQC inspection and the actions being taken to address issues relating to the delivery and performance of the Practice Plus Group run service.

Both the responses and the briefing note, (circulated on 19 May 2023), were noted at the meeting at the committee meeting on 23 May 2023 and supplementary documents with the agenda for that meeting. The documents can be viewed here. 

Chair of the Gloucestershire Health Overview and Scrutiny Committee, Cllr Andrew Gravells, confirmed that, in response to the committees concerns, HOSC would continue to work closely with the Care Quality Commission to monitor performance, and to ensure the safe and effective delivery of the GP Out of Hours Service in Gloucestershire.

Committee discussion at the meeting on 23 May 2023

In response to updates provided at committee meetings held on 15 November 2022 and 14 March 2023, the committee emphasised the need to make improvements to the GP Out of Hours Service provided by the Practice Plus Group (PPG).

Responding to concerns about the ‘requiring improvement’ classification accredited by the Care Quality Commission, (CQC), following an inspection of the service in November 2022, members engaged in an in-depth discussion  ...  view the full minutes text for item 3.

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 submitting a representation follows Gloucestershire County Council Constitution rules for making representation 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 agenda for that meeting’.

For meetings of the Health, Overview and Scrutiny Committee, notification of the intention to make representation is required three clear working days before the date of the meeting, (excluding the day of the meeting). Where the person making the representation attends the meeting in person, that individual will be invited to address the committee, (3 minutes per representative), to respond to the information provided in the written response to the original representation.

Please submit any representations for the committee meeting on 23 May 2023 to jo.moore@gloucestershire.gov.uk before 4.00 pm on Wednesday 17 May 2023.

                .

No public representations at this meeting.

Chair, Cllr Andrew Gravells, referred to several additional questions that had been submitted by Mr Keith Smith, (Mr Smith made representation at the committee meeting on 14 March 2023). With members agreement, the Chair noted the questions at the meeting and asked NHS Gloucestershire to respond by providing written responses. The Chair also offered to contact Mr Smith direct to discuss his concerns. Actions by NHS Gloucestershire/Cllr Andrew Gravells  

An update from the South Western Ambulance Service Foundation Trust.

Stephanie Bonser, (County Commander), will join the meeting remotely to respond to questions. To aid the discussion, it is suggested members submit any questions in advance of the meeting to allow for a more detailed response.

The committee received an update from the County Commander of the South Western Ambulance Service Foundation Trust.

The update included references to the recently launched new five-year Trust Strategy and to ambulance response times defined by local authority area.

Highlighted within the report was the piloting of a Mental Health Rapid Response Vehicle (MHRRV) to enhance the existing street triage/rapid response service in the South Gloucestershire area. It is hoped the pilot will help inform the future SWASFT mental health strategy. The response vehicle to operate between Monday to Thursday from 1400 to midnight and will be driven by a SWASFT Emergency Care Assistant (ECA) with a Mental Health Clinician on board.

Welcoming the piloting of the rapid response vehicle pilot, members representing the Forest of Dean and Cotswold Districts upheld concerns about ambulance response times in rural areas. Noting the concerns, the County Commander stated that work continued with stakeholders to improve response times in hard to reach locations. Requesting more detailed data at the next meeting, members asked what the committee might do to support SWAST in reducing ambulance response times. The County Commander stated that focusing on the issue of inappropriate demand impacting on the service, raised awareness of when to call an ambulance would be useful, in addition to providing information on services provided by other sources, including Pharmacies.

It was agreed that the issue of handover delays was a whole system issue and not specific to the ambulance service.

Referencing links between the work of the NHS 111 team and SWAST, it was suggested that the relationship be explored in a piece of work recently commissioned by NHS Gloucestershire and the County Council. Noting that the work would be undertaken by Newton Europe later in the year, the committee requested an update at a future meeting. Action by – NHS Gloucestershire

Commending the progress being made, the County Commander was thanked for the update.

An update on the temporary service changes at the Aveta Birthing Unit, (Cheltenham General Hospital), and Stroud Maternity Unit. Following an extension of the arrangements in January 2023, a review of the changes was made in April 2023.

The committee to note the attached Memorandum of Understanding relating to the extension of the following temporary service changes: -

a)    Cheltenham Birthing Unit to remain closed to births for a further 6-month period (review date July 2023)

b)    Stroud post-natal beds to remain closed for a further 6-month period (review date July 2023)

The committee received an update on the temporary service changes at the Aveta Birthing Unit, (Cheltenham General Hospital), and the Stroud Maternity Unit. Following an extension of the arrangements in January 2023, a review of the changes was made in April 2023.

The committee noted the Memorandum of Understanding that had been circulated with the agenda relating to the further extension of the following service changes: -

Ø  Cheltenham Birthing Unit to remain closed to births for a further 6-month period (review date July 2023)

Ø  Stroud post-natal beds to remain closed for a further 6-month period (review date July 2023)

The update included information on the current midwifery workforce position in Gloucestershire and the actions taken to address the recruitment and retention of midwives for the county since the last update to the committee in March 2023. The report presented at the meeting can be viewed here.

Responding to concerns about the decision to temporarily close 6 post-natal beds at Stroud Hospital in October 2022, Cllr Andrew Gravells suggested that a small delegation of members request a meeting with Health Ministers/NHS England, (either in person or via remote access), on factors affecting the recruitment and retention of midwives in the local area and the impact of such on the provision and delivery of maternity services to the residents of Gloucestershire.

Cllr Gravells agreed to contact the MP for Stroud, Siobhan Baillie, to seek her views on how to address local concerns. Action by – Cllr Andrew Gravells

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

The committee noted the Gloucestershire Integrated Care System, (ICS), Performance Report relating to the performance of the NHS Gloucestershire Integrated Care Board. The report included information on performance, quality and workforce. The report was taken as read.

During the meeting, members attention was drawn to a breaking news item from Sky TV and a feature on Wotton Lawn Hospital. An urgent briefing was requested (provided by NHS Gloucestershire later that day). Since the meeting, Cllr Gravells has arranged to meet with Douglas Blair, CEO of Gloucestershire Health and Care, to discuss current issues.

A report from the NHS Gloucestershire Integrated Care Board (ICB), known collectively as NHS Gloucestershire. The report to include updates from Integrated Care System (ICS) partners responsible for overseeing the day-to-day commissioning and provision of NHS services in Gloucestershire.

The NHS Gloucestershire Integrated Care Board, (ICB), report was taken as read at the meeting. The report included updates from Integrated Care System (ICS) Partners with responsibility for overseeing the day-to-day commissioning and provision of NHS services in Gloucestershire.

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

The committee noted the dates of future meetings: -

11 July 2023

10 October 2023

28 November 2023

It was noted that at the Corporate Scrutiny Committee meeting on 19 April 2023, the committee had received an update on Motion 910 Tackling the Crisis in NHS Dentistry. At the meeting, it was agreed HOSC should continue to monitor the position, in addition to considering a report with a specific focus on issues impacting on the recruitment of dental professionals.