Venue: Council Chamber - Shire Hall, Gloucester. View directions
Apologies for absence
Declarations of Interest
No additional declarations made
3.1 The minutes of the meeting on 19 November 2019 were agreed as a correct record subject to the following amendment.
Nick Relph listed as an attendee.
3.2 In relation to actions
arising, one member queried whether the detailed answer in relation
to a public question at the last meeting had been circulated. This
would be followed up.
3.3 Members were informed that a visit had been arranged to the Aspen Centre and a brief report would be circulated. The Chair thanked the Centre for the openness with which they answered questions and the your of the building. It had been a positive visit and the Chair noted the input of the CCG and Patient Participation Group in driving significant change in the practice.
3.4 In relation to a question on 62 day cancer targets, Deborah Lee explained she would welcome an opportunity to bring members up to speed on the progress against Cancer Strategy at a future meeting of the committee. The Chair suggested that members may wish a set up a short task group looking into cancer care for the County but this would need to be properly scoped. Further consideration would be given at the next work planning meeting.
ACTION – Work Planning
The Health Overview and Scrutiny Committee is 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 presentation on any matter which relates to any item
on the Health Overview and Scrutiny agenda for that meeting.
Notification of your intention to attend the meeting and make a representation
should be given by 4pm three clear working days before the date of the meeting.
The closing date for notification is 4pm on 8 January 2020.
Please email firstname.lastname@example.org
If any individual has any particular requirements please include in the email.
No representations were made.
The Chair outlined that she had received
positive feedback on the opportunity for public representations
being made available. One member asked whether there had been any
publicising of the facility and suggested a greater use of social
media. This would be reviewed as part of the reflection following
on from the previous year’s scrutiny review process.
The full report and appendices can be found
5.1 Mary Hutton introduced the output of the Fit for the Future engagement. This engagement sought views on the future provision of urgent and specialist hospital care in Gloucestershire. The comprehensive report could be found at www.onegloucestershire.net. Members were informed that the Citizen’s Jury process would begin week commencing 20 January 2020 and was the final element of the engagement.
5.2 Becky Parish outlined that the engagement was an opportunity to talk about the way in which services could be organised to get the best urgent advice, support and care across Gloucestershire as well as the benefit of having two thriving specialist hospitals in future in Cheltenham and Gloucester. It was important to find out what mattered to people. The CCG had outlined that they felt that it was important to make it easier, faster and more convenient to get advice and services 7 days a week, ensuring care was coordinated, with most care provided in or near home with services of high quality in the right place with the right staff, skills and equipment.
5.3 The engagement process asked the public and staff to help develop ideas and outline what was important to them. In particular it was about feedback on ideas for ‘centres of excellence’ approach and to develop potential solutions for specialist services. In addition the public was asked to consider the new hospital for the Forest of Dean.
5.4 Members were informed of the number of people that had been involved, over 3300 (number rounded down) local people had participated in planned activities, but the focus of engagement was not about numbers, it was about receiving qualitative feedback from a broad range of people. Members noted the views on the website and the number of surveys completed (1230). A number of surveys were responded to with the same response. 153 Forest of Dean Hospital surveys had been completed.
5.5 The team had worked with Inclusion Gloucestershire to ensure the voices of people with protected characteristics were heard. A range of demographic data had been collected and this broadly represented the local population profile. The exception was a high response rate from people with a Cheltenham postcode and people identifying as an unpaid carer. No weighting had been applied to feedback and was reported to the appendices of the output report.
5.6 Members were informed of the main feedback themes noting that Cheltenham was a focus of a number of the responses, including Cheltenham A & E. Feedback on 111 had been more positive than it had been previously but there still needed to be improved confidence in the service. Quality and Equity of services were featured in a number of responses.
5.7 It was explained that there was some reservations within the feedback as to whether acute medicine was a specialism and a number of conversations were held explaining the expertise and specialist skills required. Mental health in emergency and urgent services was a theme, with respondents keen that provision for this be built into services. ... view the full minutes text for item 5.
6.1 Mary Hutton presented the performance report explaining that there continued to be system pressure within urgent care. In relation to delayed transfers of care, work continued in this area within an improvement on the previous two months. The issue around non-obstetric ultrasound had been resolved. In relation to the Cancer two week wait, performance was good.
6.2 One member commented that he understood that the CCG and Virgin Health were working with south west ambulance to treat falls at the individual’s home and that action had greatly reduced hospital admissions. He asked whether this was a service that was available or being considered in Gloucestershire. In response it was explained that this type of approach was carried out in Gloucestershire and that details could be provided.
ACTION Mary Hutton
6.3 One member commended the service on the improved performance for timeliness in Children mental health. He noted that the information outlined that this was predicted to continue assuming that demand in the service was stable and that all planned staff recruitment and retention strategies were successful. It was explained that best estimates were considered, but there was a plan which was being followed and additional resources had been put in place
6.4 The Chair commented that she had received good feedback from the communities about GPs being able to contact consultants in order to get expert advice. It was explained that this was one of a number of tools available to GPs for advice and guidance. Cinapsis provided a direct link to an acute consultant on call.
7.1 Mary Hutton introduced the report explaining that the focus of the report was on ‘enabling activate communities.’ She emphasised the engagement from the voluntary sector, district councils and County Council.
7.2 The Committee was informed that there were currently 155 schools taking part in the Daily Mile. One member praised the initiative and asked whether it could be rolled out further than schools such as within the work place. In response it was explained that there was a Workplace Wellbeing Charter and a number of initiatives in place such as Park Run.
8.1 Mary Hutton introduced the report outlining the updates on Adverse Childhood Experiences and the Integrated Care System (ICS) Workforce and Organisational Development update.
8.2 Members noted the update on the Dermatology Training Day that had been held on 10 October 2019. Dr Andy Seymour explained that there were a number of routes available for all GPs to seek advice and help support the patient. He would discuss details with one member who outlined concerns he had from a personal experience.
8.3 One member asked for assurances regarding the Phlebotomy service explaining that he had heard risks that the service at Cheltenham could be closed down and individual GP services expected to pick up the workload. It was explained that those blood tests requested within hospital were carried out at hospital. There would be no change to any of those services. In terms of primary care, for historical reasons, it was currently a mixed picture within some practices referring those requiring a blood test to hospital which put pressure on services. Many GP surgeries carried out their own blood tests and the aim was to standardise the approach. Some surgeries would need to employ additional staff to carry out blood tests and would receive funding along with that. Members were informed that some confusion had been caused by an old notice with incorrect information that might have given the impression that services were closing, this was not the case. One member complimented the Phlebotomy service from personal experience.
8.4 One member praised the ‘Stop! Think…’ campaign and asked the high impact video content could be made more widely available. In response it was agreed that a link would be provided.
ACTION Becky Parish
8.5 Deborah Lee reminded the committee of the Trust’s decision in 2019 to set aside the General Surgery pilot, and explained that the Trust had continued to closely monitor the impact of this decision on the service and its patients. Health partners were now commencing a dialogue on further proposals for General Surgery, in light of the increasingly unsustainable nature of the controls and mitigations in place and the expectation was that something would be brought to a meeting in the near future.
The Committee to note the agreed Memorandum of Understanding.
Members noted the agreed Memorandum of Understanding, which would be reviewed annually or sooner as necessary.
Deborah Lee thanked the Chair for her work over the past two and a half years, noting that this was her last meeting, and stated that while there had been some challenges over that time she had chaired the committee superbly and that health partners had felt listened to. The Committee member echoed the thanks.